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肝功能异常患者自身免疫抗体检测的临床意义

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目的:探索自身免疫抗体检测对肝功能异常患者的临床意义。方法:选取 2019 年 1 月 1 日至 2021 年12 月 31 日于三门峡市中心医院因肝功能异常就诊的患者 478 例为研究对象,予以所有患者肝功能相关指标检查,并应用免疫印迹法检测抗核抗体(ANA)、抗双链脱氧核糖核酸抗体(dsDNA)、抗U1RNP/Sm抗体(U1RNP/Sm)、抗SSA/Ro抗体(SSA/Ro)、抗SSB/La抗体(SSB/La)、抗Jo-1抗体(Jo-1)、抗ScI-70抗体(ScI-70)、抗rRNP抗体(rRNP)、抗CENP抗体(CENP)、抗磷脂抗体(APL)、抗中性粒细胞胞浆抗体(ANCA)、类风湿因子(RA)、抗环瓜氨酸多肽抗体(CCP)、抗角蛋白抗体(AKA)及人类白细胞抗原B27(HLA-B27)在内的抗体的表达情况,分析患者的自身抗体在不同肝脏疾病中的检出情况,探讨有明确病因时患者的阳性自身抗体数量与肝功能异常的关系,及无明确病因时患者的自身抗体与肝功能的关系。结果:存在明显病因的肝功能异常患者的自身免疫抗体以ANA为主;3 种及以上自身免疫抗体阳性患者的ALT、AST、TBIL及ALP水平明显高于无自身抗体及1种自身抗体阳性的患者,差异均具有统计学意义(P<0。05);无明确病因患者自身抗体阳性数目与ALT、AST水平呈正相关(rALT=0。321,rAST=0。347,P均<0。001),与TBIL、ALP水平无明显相关性(rTBIL=0。301,rALP=0。298,P均>0。05)。结论:存在肝功能异常的患者仍有可能存在自身免疫性抗体的阳性,而无论有无明确病因,患者的自身抗体阳性数量均与肝功能指标存在相关性。
Clinical Significance of Autoimmune Antibody Detection in Patients with Abnormal Liver Function
Objective To explore the clinical significance of autoimmune antibody detection in patients with abnormal liver function.Methods A total of 478 patients with abnormal liver function who were admitted to Sanmenxia Central Hospital from January 1,2019 to December 31,2021 were selected as the study objects,and liver function related indexes of all patients were examined.Anti-nuclear antibody(ANA),anti-double-stranded deoxyribonucleic acid antibody(dsDNA),anti-U1RNP/Sm antibody(U1RNP/Sm),anti-SSA/Ro antibody(SSA/Ro),anti-SSB/La antibody(SSB/La),anti-Jo-1 antibody(Jo-1)and anti-ScI-70 antibody(ScI-70),anti-rRNP antibody(rRNP),anti-CENP antibody(CENP),anti-phospholipid antibody(APL),anti-neutrophil cytoplasmic antibody(ANCA),rheumatoid factor(RA),anti-cyclic citrulline polypeptide antibody(CCP),anti-keratin antibody(AKA),and human leukocyte antigen B27(HLA-B27)were detected by Western blot.To analyze the detection of autoantibodies in patients with different liver diseases,and explore the relationship between the number of positive autoantibodies and liver function abnormalities in patients with a clear cause,and the relationship between the number of autoantibodies and liver function in patients with no clear cause.Results ANA was the main autoimmune antibody in patients with liver dysfunction with obvious etiology.The levels of ALT,AST,TBIL and ALP in patients with three or more autoimmune positive antibodies were significantly higher than those in patients with no autoantibodies and one positive autoantibody,the differences were statistically significant(P<0.05).The number of positive autoantibodies in patients with no clear cause was positively correlated with ALT and AST levels(rALT=0.321,rAST=0.347,P<0.001),but had no significant correlation with TBIL and ALP levels(rTBIL=0.301,rALP=0.298,P>0.05).Conclusion Patients with abnormal liver function may still have positive autoimmune antibodies,and the number of positive autoantibodies in patients is correlated with liver function indicators regardless of whether there is a clear cause.

Abnormal liver functionAutoimmune antibodiesAntinuclear antibody

杨青、仝海燕

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三门峡市中心医院,河南 三门峡 472000

肝功能异常 自身免疫抗体 抗核抗体

2024

深圳中西医结合杂志
深圳市中西医结合临床研究所

深圳中西医结合杂志

影响因子:0.692
ISSN:1007-0893
年,卷(期):2024.34(9)