Comparison of clinical manifestations,serological and immunological parameters and pathological features of PBC patients with positive or negative anti-mitochondrial antibody
-
摘要: 目的:探讨抗线粒体抗体(AMA)阳性和阴性的原发性胆汁性肝硬化(PBC)患者的临床表现、血清学和免疫学指标及病理特征。方法:选取98例PBC患者,采用间接免疫荧光法测定AMA和AMA-M2,两者均为阳性者即为AMA阳性组,均阴性者为AMA阴性组。观察比较2组患者的临床表现、血清学和免疫学指标、病理特征。结果:98例PBC患者中,AMA阳性组有81例(82.7%),AMA阴性组有17例(17.3%)。2组患者的临床表现、血清学指标、病理特征和分期间的差异均无统计学意义(均P>0.05)。AMA阳性组患者IgM水平均明显高于AMA阴性组,AMA阳性组患者ANA、SMA阳性率均明显低于AMA阴性组,差异有统计学意义(P<0.05)。结论:AMA阳性与阴性PBC患者的临床表现、血清学指标、病理特征和分期相似,但AMA阳性PBC患者的血清IgM水平升高,ANA、SMA阳性率降低。Abstract: Objective:To investigate the clinical manifestations,serological and immunological parameters and pathological features of primary biliary cirrhosis(PBC)patients with positive or negative anti-mitochondrial antibody.Method:A total of 98 patients with PBC were chosen,whose AMA and AMA-M2 were detected by indirect immunofluorescence assay.Both of them were positive for AMA positive group and negative for AMA negative group.The clinical manifestations,serological and immunological parameters and pathological features of the two groups were observed and compared.Result:Of all the 98 PBC patients,81(82.7%)were AMA-positive and 17(17.3%)were AMA-negative.There were no significant differences in the clinical manifestations,serological parameters,pathologic features and stages between the two groups(P>0.05).IgM levels in patients with AMApositive group were significantly higher than those in AMA-negative group.The positive rates of ANA and SMA in AMA-positive group were significantly lower than those in AMA-negative group(P<0.05).Conclusion:The clinical manifestations,serological indicators,pathological features and staging are similar between the AMA-positive group and AMA-negative group,but the IgM level is increased and the positive rate of ANA and SMA are decreased in AMA-positive patients with PBC.
-
-
[1] Bowlus C L,Gershwin M E.The diagnosis of primary biliary cirrhosis[J].Autoimmun Rev,2014,13:441-444.
[2] 何海龙,陈杨荣,斯厚刚,等.肝硬化患者腹腔镜与开腹胆囊切除术后免疫炎症功能变化的对比研究[J].全科医学临床与教育,2014,12(1):33-35.
[3] 李勇,王金湖,张悦梅,等.抗线粒体抗体在原发性胆汁性肝硬化筛查中的应用[J].临床检验杂志,2016,34(1):73-75.
[4] Saverino D,Pesce G,Antola P,et al.High Levels of Soluble Ctla-4 Are Present in Anti-Mitochondrial Antibody Positive,but Not in Antibody Negative Patients with Primary Biliary Cirrhosis[J].PLoS One,2014,9:e112509.
[5] Teathcote EJ.Management of primary biliary cirrhosis.The American Association for the study of liver disease practice guidelines[J].Hepatology,2000,31:1005-1013.
[6] 郑俐婷.原发性胆汁性肝硬化患者血清自身免疫性肝病相关自身抗体谱的检测及临床意义[J].中国急救医学,2015,35(z2):131-132.
[7] Carbone M,Mells GF,Pells G,et al.Sex and age are determinants of the clinical phenotype of primary biliary cirrhosis and response to ursodeoxycholic acid[J].Gastroenterology,2013,144:560-569.e7.
[8] 何刚,李宏波.肝炎后肝硬化血象及骨髓象的临床分析[J].全科医学临床与教育,2014,12(2):188-189.
[9] Juliusson G,Imam M,Björnsson ES,et al.Longterm outcomes in antimitochondrial antibody negative primary biliary cirrhosis[J].Scand J Gastroenterol,2016,51:745-752.
[10] 罗莉丽,周璐,张洁,等.血清自身抗体在诊断抗线粒体抗体阴性的原发性胆汁性肝硬化中的价值[J].中华消化杂志,2015,35(2):86-89.
[11] Deng C,Hu C,Wang L,et al.Serological comparative proteomics analysis of mitochondrial autoantibody-negative and-positive primary biliary cirrhosis[J].Electrophoresis,2015,36:1588-1595.
[12] 何丽芬,赖伊杰,赖力英,等.原发性胆汁性肝硬化的临床特点[J].中南大学学报(医学版),2015,40(12):1333-1339.
[13] Tanaka H,Zhang W,Yang G X,et al.Successful immunotherapy of autoimmune cholangitis by adoptive transfer of forkhead box protein 3+regulatory T cells[J].Clin Exp Immunol,2014,178:253-261.
[14] 罗莉丽,周璐,王邦茂.抗线粒体抗体阴性原发性胆汁性肝硬化患者的临床,生化和病理学特点[J].山东医药,2014,54(7):5-8.
[15] Invernizzi P,Gershwin ME.New therapeutics in primary biliary cirrhosis:will there ever be light?[J].Liver Int,2014,34:167-170.
-
计量
- 文章访问数: 431
- PDF下载数: 194
- 施引文献: 0