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目的探讨抗中性粒细胞胞浆抗体(ANCA)对自身免疫性肝炎的检测意义。方法选择210例肝功能异常患者,其中自身免疫性肝炎(AIH)41例,原发性胆汁性肝硬化(PBC)19例,原发性硬化性胆管炎(PSC)3例,其他肝功能异常患者147例。应用间接免疫荧光法和免疫印迹法检测ANCA及其他相关自身抗体,并对患者临床资料进行分析比较。结果本组患者中,ANCA阳性16例,占肝功能异常患者的7.6%。16例ANCA阳性患者中AIH11例,PSC3例,慢性乙型肝炎1例,药物性肝损伤1例。41例AIH中,11例ANCA阳性(11/41,26.8%),同时伴有ANA阳性,核型以均质型为主(8/11,72.7%);30例ANCA阴性者中,25例ANA阳性,核型多样化,均质型仅占20.0%(6/30)。结论本研究中AIH中的ANCA阳性率仅为26.8%,以高滴度为主;ANCA阳性AIH患者ANA均阳性,其核型以均质型为主,且未观察到特殊的临床特征。
Objective To investigate the significance of anti-neutrophil cytoplasmic antibody (ANCA) on autoimmune hepatitis. Methods Totally 210 patients with abnormal liver function were selected, including 41 cases of autoimmune hepatitis (AIH), 19 cases of primary biliary cirrhosis (PBC), 3 cases of primary sclerosing cholangitis (PSC) and other abnormal liver function 147 patients. Indirect immunofluorescence and Western blotting were used to detect ANCA and other autoantibodies. The clinical data of patients were analyzed and compared. Results In this group of patients, ANCA positive in 16 cases, accounting for 7.6% of patients with liver dysfunction. Among 16 ANCA-positive patients, 11 were AIH, 3 were PSC, 1 was chronic hepatitis B, and 1 was drug-induced liver injury. Eleven of the 41 cases of AIH were positive for ANCA (11/41, 26.8%), with positive ANA and homogeneous karyotype (8/11, 72.7%). Among 30 ANCA-negative patients, 25 ANA positive, karyotype diversity, homogeneous only accounted for 20.0% (6/30). Conclusions The positive rate of ANCA in AIH was only 26.8% in this study, which was mainly high titer. The ANA in patients with ANCA positive AIH were all positive, and the karyotypes were homogeneous, and no special clinical features were observed.