摘要
目的分析乙肝病毒(HBV)感染者血清中抗核抗体(ANA)的特征并探讨其与临床的相关性。方法慢性乙型肝炎(CHB)、乙肝后肝硬化(LC)、原发性肝癌(HCC)患者共569例,采用间接免疫荧光法(IIF)检测ANA、AMA、SMA、LSP等自身抗体;免疫印迹法检测ANA谱。结果1)569例中ANA阳性245例(43%),CHB、LC、HCC组ANA检出率分别为42.1%(90/214)、38.2%(108/283)、65.3%(47/72),3组均明显高于正常对照组6.7%(2/30),HCC组ANA阳性率显著高于CHB组和LC组(P<0.01)。2)CHB、LC和HCC组ANA以低滴度(1∶100)为主,分别为75.6%(68/90)、68.5%(74/108)、66%(31/47)。3组中ANA荧光模式以颗粒型常见;抗核仁型抗体的比例在HCC组中最高为19.1%(9/47)。3)45例ANA≥1∶320的患者检测了ANA谱,仅2例LC患者dsDNA阳性,1例LC患者SSA阳性,余患者阴性。4)ANA滴度1∶100组与≥1∶320组的ALT、AST、HBVDNA各指标比较,差异无统计学意义。结论HBV感染者出现的自身抗体以ANA为主,HCC组阳性率最高。ANA荧光模式以颗粒型常见,核仁型在HCC和LC组高于CHB组。70.6%的HBV感染者ANA为低滴度阳性,其滴度的高低与肝细胞损伤未见明显相关性。
Objective To investigate the characteristics of anti-nuclear antibodies and its clinical implication in patients with hepatitis B virus infection. Methods 569 patients with hepatitis B virus infection including 214 with chronic hepatitis B, 283 with liver cirrhosis and 72 with hepatocellular carcinoma were recruited. 30 healthy volunteers were as control. Indirect immune fluorescent assay （IIF） was used to detect the serum anti-nuclear antibody （ANA）, anti-mitochondrial antibody （AMA）, anti-smooth muscle antibody （SMA） and anti-liver special protein （LSP）. Western blot was used to detect ANA profile. Results 1 ） 245 of the 569 patients with Hepatitis B virus infection （43%） were ANA positive, 90/214 （42. 1% ） in CHB group, 108/283 （38.2%） in LC group, 47/72 （65.3%） in HCC group. HCC had a significantly higher percentage of ANA than CHB, LC and healthy volunteers（6.7% ）. 2） Among the 3 groups, low titer （ 1： 100） of anti-nuclear antibodies was more common. Although a rage of fluorescent patterns was observed, the percentage of granular fluorescence was highest in the 3 groups. The percentage of anti-nueleolar antibody in HCC group（ 19.1% ） was higher than CHB（ 4.4% ） and LC （ 18.5 % ） （ P 〈 0.01 ）. 3） ANA profile was detected in 45 patients with titer of ANA ≥ 1： 320. dsDNA was positive in 2 patients with LC , and SSA in 1 patients with LC. 4） In terms of the serum levels of ALT, AST and virus load there were no significant differences between titer of ANA 1：100 and 1：320 in each group. Conclusion Anti-nuclear antibodies（ANA） were main auto-antibody in patients with hepatitis B virus infection, especially in patients with HCC. The titer of ANA had no significant implication with fiver damage.
出处
《首都医科大学学报》
CAS
2007年第2期154-157,共4页
Journal of Capital Medical University
基金
国家自然科学基金(30571723)
北京市自然科学基金(7062033)资助项目
关键词
自身抗体
抗核抗体
慢性乙型肝炎
肝肿瘤
免疫荧光模式
auto-antibody
anti-nuclear antibodies
chronic hepatitis B
hepatocellular carcinoma（HCC）
immune fluorescent patterns
