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目的 观察我国不同类型肝病患者中几种抗肝抗原自身抗体的存在状况 ;探讨自身免疫性肝脏疾病的自身抗体特征。方法 由 14 12例标本中选择 2 30例肝功能异常患者分为 5组 :①自身免疫性肝病组 4 2例 :自身免疫性肝炎 (AIH) 18例、原发性胆汁性肝硬化 (PBC) 2 1例、原发性硬化性胆管炎 (PSC) 3例。②HAV组 2 3例 ;③HBV组 70例 ;④HCV组 35例 ;⑤非甲～戊型肝炎组 6 0例。用间接免疫荧光、Westernblot、酶免疫条带技术等分别检测抗核抗体 (ANA)、抗线粒体抗体(AMA)、平滑肌抗体 (SMA)、肝肾微粒抗体Ⅰ型 (LKM 1)、肝细胞胞溶质抗原Ⅰ型 (LC 1)、可溶性肝抗原 (SLA) 肝胰抗原 (LP)和AMA M2亚型 ,以及SS A、SS B、dsDNA等多种抗体。结果 14 12例中诊断AIH、PBC和PSC者分别为送检标本的 1.2 7% ,1.4 9%和 0 .2 1%。 2 30例血清中 2例LKM 1阳性和 2例SLA LP阳性 ,分别见于AIH和HCV感染者。PBC患者AMA和M2全部阳性 ;其ANA以核膜型为主 (7 14 ) ;AIH患者ANA抗体未见特定的荧光类型 ,而抗 Actin仅见于AIH者。非甲～戊组 4例AMA和M2阳性 ,3例SMA高滴度阳性 ,4例出现SS A、SS B或dsDNA等抗体。结论 肝抗原抗体和ANA及AMA分型的检测有助于自身免疫性肝病和重叠多种免疫性肝病的诊断 ;非甲～戊型肝炎诊断时应?
Objective To observe the existence of several autoantibodies against liver antigens in patients with different types of liver diseases in China and to explore the characteristics of autoantibodies against autoimmune liver diseases. Methods Forty-two patients with abnormal liver function were enrolled in this study. Among them, 42 patients with abnormal liver function were selected from 14 12 patients. ① In the autoimmune liver disease group, 42 patients were diagnosed as autoimmune hepatitis (AIH), 18 with primary biliary cirrhosis (PBC) 21 cases, primary sclerosing cholangitis (PSC) in 3 cases. ② 23 cases of HAV group; ③ 70 cases of HBV group; ④ 35 cases of HCV group; ⑤ 60 cases of non-hepatitis A-hepatitis group. ANA, SMA, SMA, LKM 1, hepatocyte cytosol were detected by indirect immunofluorescence, Western blot and enzyme immunoassay. LC1, SLA and LPA subtypes, as well as SS A, SS B and dsDNA. Results Among the 12 cases, AIH, PBC and PSC were diagnosed respectively, which were 1.2 7%, 1.4 9% and 0.2 1% of the samples tested. Two of the 30 serum samples were positive for LKM 1 and two for SLA LP, respectively, in AIH and HCV-infected individuals. ABC and M2 were all positive in PBC patients. The majority of ANA was nuclear membrane type (7 14). There was no specific fluorescence type of ANA antibody in AIH patients, but only AIH in anti-Actin. 4 cases of AMA and M2 were non-A to E group, 3 cases of high titer of SMA were positive, and 4 cases appeared SS A, SS B or dsDNA and other antibodies. Conclusions The detection of liver antigen antibody, ANA and AMA classification is helpful for the diagnosis of autoimmune liver disease and overlapping multiple immune liver diseases.