原发性胆汁性胆管炎患者血清自身抗体和临床特征分析*

doi:10.3969/j.issn.1672-5069.2020.04.016

实用肝脏病杂志 ›› 2020, Vol. 23 ›› Issue (4): 516-519.doi: 10.3969/j.issn.1672-5069.2020.04.016

原发性胆汁性胆管炎患者血清自身抗体和临床特征分析^*

李文渊, 叶超, 李磊, 方芳, 陈思, 王陆军, 张开光

230000 合肥市中国科学技术大学附属第一医院感染病科(李文渊,李磊);消化科(叶超,张开光,方芳,陈思,王陆军)

收稿日期:2019-05-28 发布日期:2020-07-15
通讯作者: 叶超,E-mail:yechao850606@163.com
作者简介:李文渊,男,34岁,硕士研究生,主治医师。主要从事疑难肝病和肝衰竭发病机制研究。E-mail: ct2037@163.com
基金资助:
*安徽省自然科学青年基金资助项目(编号:1908085QH331);中国科学技术大学新医学联合基金资助项目(编号:WK9110000023)

Prevalence of serum autoantibodies and clinic features in patients with primary biliary cholangitis

Li Wenyuan, Ye Chao, Li Lei, et al

Department of Infectious Diseases and Department of Gastroenterology, First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China

Received:2019-05-28 Published:2020-07-15

摘要/Abstract

摘要： 目的原发性胆汁性胆管炎(PBC)是我国常见的一种自身免疫性肝病,本研究对PBC患者血清自身抗体阳性情况和临床特征进行了分析,以期为其临床诊治提供参考。方法回顾性分析我院住院诊治的230例PBC患者的临床资料,采用欧盟试剂检测血清抗线粒体抗体(AMA和AMA-M2)、抗核糖核蛋白(RNP)抗体、抗SSA60、抗SSA52、抗SSB、抗着丝点蛋白B(CENP-B)、抗双链DNA(dsDNA)、抗组蛋白、抗Sp100、抗gp210和抗核小体抗体(ANua)等。分析合并其他自身免疫性疾病,包括干燥综合征(SS)和系统性红斑狼疮(SLE)等。结果在230例PBC患者中,AMA-M2阳性167例(72.6%),抗gp210阳性101例(43.9%),抗Sp100阳性39例(17.0%);在所有PBC患者中,有178例(77.4%)ANA阳性;血清抗SSA52和抗CENP-B阳性率分别为37.4%和20.0%;在所有PBC患者中,合并SS者54例(23.5%),合并SLE者 21例(9.1%);与156例代偿期肝硬化比,74例失代偿期患者血清抗gp210和抗SSA52阳性率显著升高,分别为63.5%对34.6%(P<0.05)和(44.6%对29.5%,P<0.05),差异有统计学意义。结论本研究发现血清AMA-M2、抗gp210和抗Sp100等仍然是诊断PBC的特征性指标。PBC患者血清抗SSA52和抗CENP-B阳性率也较高,可以作为补充诊断的潜在指标。本研究还发现血清抗gp210和抗SSA52阳性可能提示PBC病情较严重。SS和SLE作为PBC患者的常见合并症,其具体的发病机制和与疾病进程的关系,仍值得我们进一步的深入研究。

关键词: 原发性胆汁性胆管炎, 自身抗体, 诊断

Abstract: Objective Primary biliary cholangitis (PBC) is a common autoimmune disease all over the world. The aim of this study was to investigate prevalence of serum autoantibodies and clinic features in patients with PBC. Methods A retrospective analysis was performed on 230 patients with PBC. All clinic characteristic and serum autoantibodies including Anti-Sm, RNP, SSA60, SSA52, SSB, CENP-B, dsDNA, antihistone antibodies, AMA-M2, Sp100, gp210 and ANua, were assayed. Other autoimmune diseases, such as Sjogren syndrome (SS), systemic lupus erythematosus (SLE) were recorded. Results Out of the 230 patients with PBC, the prevalence of serum AMA-M2, anti-gp210 and anti-Sp100 were positive in 167(72.6%), 101(43.9%), and 39(17%) patients; serum ANA was positive in 178(77.4%) patients; serum anti-SSA and anti-CENP-B were positive in 37.4% and 20.0% in spite of positive serum autoantibodies above; SS and SLE were found in 54 and 21 patients (23.5% and 9.1%); anti-gp210 and anti-SSA52 had a higher positive rates in 74 patients with decompensated liver functions (63.5% vs. 34.6%,P <0.05 and 44.6% vs. 29.5%, respectively, P <0.05) as compared to those in 156 patients with compensated liver functions. Conclusion Serum AMA-M2, anti-GP210 and anti-Sp100 are still key diagnostic index, and serum anti-SSA52 and anti-CENP-B have relatively high positive rate in patients with PBC. We also found that the patients with positive anti-gp210 and anti-SSA52 might have a severe liver disease.

Key words: Primary biliary cholangitis, Autoantibody, Diagnosis

李文渊, 叶超, 李磊, 方芳, 陈思, 王陆军, 张开光. 原发性胆汁性胆管炎患者血清自身抗体和临床特征分析^*[J]. 实用肝脏病杂志, 2020, 23(4): 516-519.

Li Wenyuan, Ye Chao, Li Lei, et al. Prevalence of serum autoantibodies and clinic features in patients with primary biliary cholangitis[J]. Journal of Practical Hepatology, 2020, 23(4): 516-519.

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原发性胆汁性胆管炎患者血清自身抗体和临床特征分析^*

Prevalence of serum autoantibodies and clinic features in patients with primary biliary cholangitis

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