原发性胆汁性肝硬化患者46例抗着丝点抗体临床检测分析
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[摘要] 目的：研究在原发性胆汁性肝硬化(primary biliary cirrhosis，PBC)患者中，抗着丝点抗体(anticentromere antibody，ACA)与临床表现之间的关系。方法：用间接免疫荧光法检测PBC患者血清抗核抗体(ANA)各荧光模式，比较ACA阳性和阴性患者临床表现的差别和免疫学指标的差别。结果：156例PBC患者中ACA阳性46例(25%)，ACA阳性组乏力、黄疸症状少于ACA阴性组，两组间有统计学差异(P<0.05)，肝功能异常症状两组间差异有统计学意义(P<0.05)，ACA阳性组多于ACA阴性组。免疫学指标中，CD4+和IgM在两组间有统计学意义，ACA阳性组高于阴性组(P<0.05)。结论：ACA阳性的PBC患者临床表现隐匿，以单纯肝功能异常多见，易造成临床上漏诊。
[关键词] 肝硬化；胆汁性；抗着丝点抗体
[中图分类号] R593.2 [文献标识码]A[文章编号]1674-4721(2011)03(b)-020-03
Detecion of clinical characteristics in 46 patients with primary biliary cirrhosis
ZHANG Aibing
Fangshan Maternal and Child Health Hospital of Beijing, Beijing 102488, China
[Abstract] Objective: To investige the clinical relationship of anticentromere antibody (ACA) in patients with primary biliary cirrhosis (PBC). Methods: ACA was detected using indirect immunofluorescence (IIF) in 156 patients with PBC, and the difference was compared between the ACA positive and negative gyoup. Results: 46 of the 156 cases in primary biliary cirrhosis were positive, the sensibility was 29%. ACA positive group fatigue, icteric symptoms ACA negative groups, less than there were significant differences between the two groups (P<0.05), liver function is abnormal symptoms between the two groups was statistically significant (P<0.05), ACA positive group than ACA negative groups. Immunological indexes, CD4+ and IgM between the two groups was statistically significant positive group, ACA-positive group was higher than negative group (P<0.05). Conclusion: The symptoms of positive of ACA is dormancy, and with a simple liver function abnormalities more common, it easily lead to clinical misdiagnosis.
[Key words] Liver cirrhosis; Biliary; Anticentromere antibody
原发性胆汁性肝硬化(PBC)是一种原因不明的、以肝内胆管进行性非化脓性炎症损伤为特征的疾病，好发于中年女性，临床表现以乏力、黄疸、瘙痒为主，抗线粒体抗体及M2亚型阳性是其主要实验室诊断指标。近年来随着国内外对此病的研究进展和诊断技术的提高，发现抗核抗体(ANA)在PBC患者中阳性率较高，仅次于抗线粒体抗体(AMA和AMA-M2)。抗核抗体荧光模式有核膜型、核点型、着丝点型等，各荧光模式在PBC的发病机制中可能不同。本文就抗核抗体(ANA)分型中的抗着丝点抗体(ACA)阳性患者与ACA阴性患者临床表现上的不同进行比较分析。
1 资料与方法
1.1 一般资料
本研究入选2006年1月～2009年12月在我院住院确诊的原发性胆汁性肝硬化患者156例 ......
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