本文選題：自身免疫性肝病　切入點(diǎn)：病毒性肝病　出處：《職業(yè)與健康》2016年01期 　論文類型：期刊論文

【摘要】：目的探討自身免疫性肝病(ALDS)患者與病毒性肝病患者檢測(cè)自身抗體與肝功能的臨床價(jià)值。方法應(yīng)用免疫印跡法和間接免疫熒光法檢測(cè)自身免疫性肝病、病毒性肝病患者和健康檢查者血清中的自身抗體,并測(cè)定每位患者的肝功能。結(jié)果 ALDS組中抗核抗體(AVA)的陽(yáng)性檢出率(88.2%)明顯高于病毒性肝病組(15.9%),差異有統(tǒng)計(jì)學(xué)意義(P0.05),在檢測(cè)肝病自身抗體時(shí)ALDS組中線粒體抗體(AMA)的檢出率為65.7%,明顯高于病毒性肝病組的0.6%(P0.01)。在肝病自身抗體中自身免疫性肝炎(AIH)的抗平滑肌抗體(SMA)陽(yáng)性率為47.2%,明顯高于原發(fā)性膽汁性肝硬化(PBC)組的17.1%,但PBC組的AMA陽(yáng)性率為95.7%,則顯著高于AIH組。AIH的ANA的核型主要為顆粒型;PBC為著絲點(diǎn)型;原發(fā)性硬化性膽管炎(PSC)為核膜型;病毒性肝病則未見(jiàn)特定熒光核型。在ALDS組與病毒性肝病組中,丙氨酸轉(zhuǎn)氨酶(ALT)、天冬氨酸轉(zhuǎn)氨酶(AST)、堿性磷酸酶(ALP)和谷氨酰轉(zhuǎn)肽酶(GGT)活力均升高,差異有統(tǒng)計(jì)學(xué)意義(P0.05),但免疫球蛋白(Ig G)差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論自身抗體對(duì)ALDS與病毒性肝病患者的診斷與鑒別有重要意義,ALDS的診斷可結(jié)合自身抗體檢測(cè)與肝功能的結(jié)果以提高診斷的準(zhǔn)確性。
[Abstract]:Objective to investigate the clinical value of autoantibodies and liver function in patients with autoimmune liver disease (ALDS) and viral liver disease. Methods Immunoblot and indirect immunofluorescence assay were used to detect autoimmune liver disease. Autoantibodies in the serum of patients with viral liver disease and health examiners, Results the positive rate of antinuclear antibody (AVA) in ALDS group was significantly higher than that in viral liver disease group (P 0.05), and the mtDNA antibody level in ALDS group was significantly higher than that in viral liver disease group (P 0.05). The positive rate of anti-smooth muscle antibody (SMA) in autoantibodies to autoimmune hepatitis of liver disease was 47.2, which was significantly higher than that in the group of primary biliary cirrhosis (PBC), but the positive rate of AMA in PBC group was higher than that in the group of primary biliary cirrhosis. The karyotype of ANA was significantly higher than that of AIH group (95.7%), and the karyotype of ANA was mainly granular type (PBC) and centromere type (P < 0.05). In ALDS group and viral liver disease group, the activities of alanine aminotransferase (alt), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and glutamyl transpeptidase (GGT) increased. The difference was statistically significant (P 0.05), but the difference of immunoglobulin G (Ig G) was not statistically significant. Conclusion autoantibodies are of great significance in the diagnosis and differential diagnosis of ALDS and patients with viral liver disease. The diagnosis of autoantibodies can be combined with the detection of autoantibodies and liver function. To improve the accuracy of diagnosis.
【作者單位】： 武漢大學(xué)人民醫(yī)院檢驗(yàn)科;
【基金】：武漢大學(xué)人民醫(yī)院國(guó)家臨床重點(diǎn)�？平ㄔO(shè)項(xiàng)目(財(cái)社[2010]305號(hào))
【分類號(hào)】：R512.6;R575

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