自身免疫性肝病患者血清IgG4水平分析

doi:10.3969/j.issn.1672-5069.2014.04.016

实用肝脏病杂志 ›› 2014, Vol. 17 ›› Issue (4): 396-400.doi: 10.3969/j.issn.1672-5069.2014.04.016

自身免疫性肝病患者血清IgG4水平分析

张敏, 韩涛, 聂彩云, 王伟, 杜卫杰, 周淑芬, 王棕覃, 孙扬, 丁贤, 朱争艳

300170 天津市天津医科大学三中心临床学院(张敏,聂彩云); 天津市第三中心医院肝内科（韩涛）; 检验科（杜卫杰,周淑芬,丁贤）; 科教科（王棕覃,孙扬）; 首都儿科研究所检验科（王伟）; 天津市人工细胞重点实验室(朱争艳)

收稿日期:2013-11-20 出版日期:2014-08-30 发布日期:2016-04-11
通讯作者: 韩涛,E-mail:hantaomd@126.com
作者简介:张敏,女,26岁,硕士研究生。主要从事肝胆疾病防治研究。E-mail: zhangmin4692@126.com

Serum IgG4 levels in patients with autoimmune liver diseases

Zhang Min, Han Tao, Nie Caiyun

Department of Hepatology and Gastroenterology,Third Central Clinical College,Tianjin Medical University,Tianjin 300170,China

Received:2013-11-20 Online:2014-08-30 Published:2016-04-11

摘要/Abstract

摘要： 目的探讨不同自身免疫性肝病患者血清免疫球蛋白G4（immunoglobulin G4,IgG4）水平差异,并分析不同血清IgG4水平的自身免疫性肝病患者临床特点的差异。方法收集自身免疫性肝病患者65例,其中自身免疫性肝炎（AIH）11例、原发性胆汁性肝硬化（primary biliary cirrhosis,PBC）47例及AIH与PBC重叠综合征7例。采用免疫散射比浊法检测三组患者血清IgG4水平,并分析三组之间血清IgG4水平的差异。根据血清IgG4水平的不同进行分组,分析不同血清IgG4水平的自身免疫性肝病患者临床特点的差异。对组间正态分布的计量资料的比较应用独立样本t检验,对非正态分布者采用Mann-Whitney U检验。计数资料的比较采用Fisher’s确切概率法。结果AIH患者血清IgG4水平为642.2 mg/L（97.7 mg/L~1687.0 mg/L）,高于PBC患者[153.9 mg/L（78.9 mg/L~400.3 mg/L）,P=0.076]及重叠综合征患者[229.9 mg/L（154.9 mg/L~417.9 mg/L）,P=0.388],无统计学差异。其中3例AIH患者血清IgG4水平异常升高（≥1350 mg/L）,与血清IgG4水平较低的8例AIH患者比,IgG4水平和IgG4/IgG比值较高,差异具有统计学意义（P<0.05）;3例血清IgG4水平≥1350 mg/L的AIH患者均合并 2型糖尿病,其中1例合并类风湿性关节炎,而其他8例AIH患者未合并其他自身免疫性或代谢性疾病;血清IgG4水平较高（IgG4水平≥200 mg/L）的14例PBC患者与IgG4水平较低的33例PBC患者比,血清总胆红素水平较高 [（45.09±74.85）μmol/L 对（26.38±23.03） μmol/L,P=0.05]。结论与PBC及PBC与AIH 重叠综合征患者比,AIH患者血清IgG4水平较高。血清IgG4水平较高的AIH患者可能较易合并其他自身免疫性或代谢性疾病。

关键词: 自身免疫性肝病, 免疫球蛋白G4, 临床特征

Abstract: Objective To study the differences of serum IgG4 levels in various autoimmune liver diseases and to analyze the clinical characterization of patients with high serum IgG4 levels. Methods 65 patients with autoimmune liver diseases were enrolled for this study including 11 patients with autoimmune hepatitis （AIH）,47 patients with primary biliary cirrhosis（PBC） and 7 patients with overlap syndrome of AIH and PBC. The serum IgG4 levels was detected by immuno-scatter turbidmetry. The differences of serum IgG4 levels in the three groups were studied. The clinical features of patients with autoimmune liver disease were analyzed according to their serum IgG4 levels. The significance of inter-group differences of measurement data was assessed by Student’s t-test or Mann-Whitney U test and enumeration data by Fisher’s exact test. Results The serum IgG4 levels in patients with AIH was 642.2 mg/L（97.7 mg/L~1687.0 mg/L）,a little higher than in patients with PBC [153.9 mg/L（78.9 mg/L~400.3 mg/L）,P=0.076] and in with overlap syndrome [229.9 mg/L（154.9 mg/L ~417.9 mg/L）,P=0.388];Three patients with AIH had high serum IgG4 levels （≥1350 mg/L） out of 11 patients with AIH. The ratio of IgG4/IgG was higher in the three patients with higher as compared to 8 with relatively low serum IgG4 levels（P<0.05）;The three patients with elevated IgG4 levels had diabetes mellitus type 2 and one of them was also complicated with rheumatoid arthritis, whereas the other 8 patients with low serum IgG4 levels were not;14 patients with PBC with higher serum IgG4 levels（≥200 mg/L） had higher total serum bilirubin levels as compared to those in 33 patients with relatively low serum IgG4 levels [（45.09±74.85）μmol/L vs.（26.38±23.03） μmol/L,P=0.05）]. Conclusion Compared with patients with PBC or overlap syndrome of AIH and PBC,the patients with AIH have a higher serum IgG4 levels. The patients with AIH with high serum IgG4 levels might be complicated with other autoimmune or metabolic diseases.

Key words: Autoimmune liver disease, Immunoglobulin G4, Clinical feature

张敏, 韩涛, 聂彩云, 王伟, 杜卫杰, 周淑芬, 王棕覃, 孙扬, 丁贤, 朱争艳. 自身免疫性肝病患者血清IgG4水平分析[J]. 实用肝脏病杂志, 2014, 17(4): 396-400.

Zhang Min, Han Tao, Nie Caiyun. Serum IgG4 levels in patients with autoimmune liver diseases[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2014, 17(4): 396-400.

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自身免疫性肝病患者血清IgG4水平分析

Serum IgG4 levels in patients with autoimmune liver diseases

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