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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。
Objective: To investigate the clinical manifestations, serological and immunological indexes and pathological features of patients with primary biliary cirrhosis (PBC) who have anti-mitochondrial antibody (AMA) positive and negative. Methods: A total of 98 patients with PBC were selected and AMA and AMA-M2 were detected by indirect immunofluorescence. AMA positive was found in both AMA positive and negative AMA negative. The clinical manifestations, serological and immunological indexes and pathological features of two groups were observed and compared. Results: Of 98 patients with PBC, 81 (82.7%) were in the AMA positive group and 17 (17.3%) in the AMA negative group. The clinical manifestations, serological parameters, pathological features and the differences between the two groups were not statistically significant (all P> 0.05). The IgM levels of AMA positive patients were significantly higher than those of AMA negative patients. The positive rates of ANA and SMA in AMA positive patients were significantly lower than those in AMA negative patients (P <0.05). Conclusion: The clinical manifestations, serological parameters, pathological features and staging of AMA positive and negative PBC patients are similar. However, the serum IgM levels of AMA positive PBC patients are elevated, and the positive rate of ANA and SMA is decreased.