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目的检测原发性胆汁性肝硬化(PBC)患者血清抗磷脂抗体(APA),探讨其在PBC中的阳性状况和临床意义。方法采用ELISA检测209例PBC患者、44例自身免疫性肝炎(AIH)患者、56例肝病对照(LDC)患者血清抗心磷脂抗体(ACL)-IgG和抗β2糖蛋白1(β2GP1)-IgG抗体。结果 PBC患者抗ACL-IgG、抗β2GP1-IgG、抗ACL或抗β2GP1-IgG抗体的阳性率分别为11.5%、19.1%、26.8%;与AIH、LDC组间的阳性率比较,差异均无统计学意义(χ12分别为0.662、0.776、0.959;χ22分别为0.327、1.34、0.073,P均>0.05);PBC患者中抗ACL-IgG、抗β2GP1-IgG抗体在抗线粒体抗体(AMA)、抗核膜糖蛋白210(GP210)抗体、抗酸性磷酸化核蛋白100(SP100)抗体的阳性组与阴性组间阳性率差异均无统计学意义(χ12分别为0.692、0.625、1.082;χ22分别为0.033、0.062、1.692;χ32分别为0.059、0.358、0.118,P均>0.05);抗β2GP1-IgG抗体阳性PBC患者的血清总胆红素(TBIL)、直接胆红素(DBIL)、天门冬氨酸氨基转移酶(AST)、总胆汁酸(TBA)、腺苷脱氨酶(ADA)、免疫球蛋白M(IgM)、红细胞沉降率(ESR)高于抗β2GP1-IgG抗体阴性PBC患者(U值分别为1407、1482、1433、1258.5、1353、716、432.5,P均<0.05或0.01),而血清白蛋白(ALB)、白蛋白/球蛋白比例(A/G)、胆碱脂酶(CHE)和前白蛋白(PA)低于抗β2GP1-IgG抗体阴性PBC患者(U值分别为1531.5、1565.5、1318.5、1357,P均<0.05或0.01)。抗ACL-IgG抗体阳性PBC患者与阴性患者肝功能损伤指标和免疫学指标差异均无统计学意义(P均>0.05)。结论 APA是PBC患者体内普遍存在的自身抗体,在PBC患者有较高的阳性率,且以抗β2GP1-IgG抗体为主。抗β2GP1-IgG抗体与PBC患者肝功能损伤指标和免疫活动指标改变有关,而抗ACL-IgG抗体与PBC患者肝功能损伤指标和免疫活动指标改变无关。
Objective To detect serum anti-phospholipid antibody (APA) in patients with primary biliary cirrhosis (PBC) and to investigate its positive status in PBC and its clinical significance. Methods Serum anti-cardiolipin antibody (ACL) -IgG and anti-β2GP1-IgG antibody were detected in 209 cases of PBC, 44 cases of autoimmune hepatitis (AIH) and 56 cases of liver disease control (LDC) . Results The positive rates of anti-ACL-IgG, anti-β2GP1-IgG, anti-ACL or anti-β2GP1-IgG in PBC patients were 11.5%, 19.1% and 26.8%, respectively. (P <0.05); anti-ACL-IgG, anti-β2GP1-IgG antibodies in anti-mitochondrial antibody (AMA), anti-nuclear There was no significant difference in the positive rates of GP210 antibody and SP100 antibody between the positive group and the negative group (χ12 = 0.692,0.625,1.082, χ22 = 0.033, 0.062,1.692; χ32 = 0.059,0.358,0.118, respectively, P> 0.05). Serum total bilirubin (TBIL), direct bilirubin (DBIL), aspartate amino AST, TBA, ADA, IgM, ESR were higher than those of anti-β2GP1-IgG negative PBC patients 1407, 1482, 1433, 1258.5, 1353, 716, and 432.5, P <0.05 or 0.01 respectively), and serum albumin (ALB), albumin / globulin ratio (CHE) and prealbumin (PA) is lower than the anti-antibody negative β2GP1-IgG PBC patients (U values were 1531.5,1565.5,1318.5,1357, P <0.05 or 0.01). There was no significant difference in the indexes of liver function damage and immunological indexes between anti-ACL-IgG positive PBC patients and negative patients (all P> 0.05). Conclusion APA is a common autoantibody in PBC patients. It has a high positive rate in patients with PBC, and mainly anti-β2GP1-IgG antibody. Anti-β2GP1-IgG antibody and PBC patients with liver damage index and immune activity changes, and anti-ACL-IgG antibody and PBC patients with liver injury and immune activity index has nothing to do.