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目的研究血吸虫病患者肝纤维化与抗中性粒细胞胞质抗体(ANCA)的关系。方法随机选取2014年2月至2016年6月期间荆州市第一人民医院确诊的血吸虫病患者145例作为病例组,随机选取同期在该院体检的健康体检者100例作为对照组,采集两组血清,通过间接免疫荧光法检测ANCA,以放射免疫法检测透明质酸、层粘蛋白、Ⅲ型前胶原和Ⅳ型胶原,比较两组上述指标的水平。结果病例组ANCA阳性率为28.96%(42/145),对照组为1.00%(1/100),差异有统计学意义(P<0.05)。病例组透明质酸、层粘蛋白、Ⅲ型前胶原和Ⅳ型胶原水平均高于对照组,4项肝纤维化指标水平异常者所占比例亦高于对照组,差异均有统计学意义(P均<0.05)。病例组中,42例ANCA阳性者中透明质酸、层粘蛋白水平异常者所占比例均高于ANCA阴性者;前者4项肝纤维化指标均值均高于相应正常参考值,其透明质酸、层粘蛋白水平平均值显著高于ANCA阴性者,差异均有统计学意义(P<0.05)。结论血吸虫病肝纤维化患者可出现自身免疫性抗体ANCA阳性,ANCA可能与肝纤维化的自身免疫过程有关。
Objective To study the relationship between liver fibrosis and anti-neutrophil cytoplasmic antibody (ANCA) in patients with schistosomiasis. Methods A total of 145 patients with schistosomiasis diagnosed in First People’s Hospital of Jingzhou City from February 2014 to June 2016 were randomly selected as the case group and 100 healthy subjects were randomly selected as the control group during the same period. Serum were detected by indirect immunofluorescence ANCA, radioimmunoassay detection of hyaluronic acid, laminin, type Ⅲ procollagen and collagen type Ⅳ, the level of these indicators were compared. Results The ANCA positive rate was 28.96% (42/145) in the case group and 1.00% (1/100) in the control group, the difference was statistically significant (P <0.05). The levels of hyaluronic acid, laminin, type Ⅲ procollagen and type Ⅳ collagen in the case group were higher than those in the control group, and the proportions of 4 abnormal liver fibrosis indicators were also higher than those in the control group P <0.05). In the case group, the percentages of hyaluronic acid and laminin were abnormal in 42 ANCA positive patients were higher than those in ANCA negative patients. The former four indicators of liver fibrosis were higher than the corresponding normal reference values, and the hyaluronic acid , The average level of laminin was significantly higher than ANCA negative, the difference was statistically significant (P <0.05). Conclusions Autoantibody ANCA positive in schistosomiasis patients with liver fibrosis may occur. ANCA may be related to the autoimmune process of hepatic fibrosis.