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目的探讨原发性胆汁性肝硬化(PBC)的免疫学实验诊断特点。方法观察85例PBC患者的临床表现,并分析有关实验室检查资料。结果本组患者临床症状不典型。所有患者γ-谷氨酰转移酶(GGT)升高,98.8%(84/85)的患者碱性磷酸酶(ALP)升高,87.1%(74/85)的患者总胆红素(TB il)和结合胆红素(CB il)升高,81.2%(69/85)的患者丙氨酸转氨酶(ALT)、78.8%(67/85)的患者门冬氨酸转氨酶(AST)、52.9%(45/85)的患者球蛋白(GLB)、95.7%(22/23)的患者总胆汁酸(TBA)、84.0%(21/25)的患者高密度脂蛋白胆固醇(HDL-C)升高。自身抗体检测有59例抗核抗体(ANA)阳性(69%),其中32例为核膜型,20例为着丝点型;85例患者抗线粒体抗体(AMA)均为阳性,其中80例(94.1%)AMA M2阳性。结论PBC无典型性临床症状,医生可以通过临床表现结合AMA,尤其是AMA M2的检测结果获得诊断信息。
Objective To investigate the immunological characteristics of primary biliary cirrhosis (PBC). Methods The clinical manifestations of 85 patients with PBC were observed, and the relevant laboratory data were analyzed. The results of this group of patients with atypical clinical symptoms. All patients had elevated GGT, elevated ALP levels in 98.8% (84/85), and total bilirubin (87.1% (74/85) in patients with TBil ) And elevated bilirubin (CBil) in 81.2% (69/85) of patients with ALT, 78.8% (67/85) in patients with aspartate aminotransferase (AST), 52.9% (45/85) of patients with GLB, 95.7% (22/23) of patients with total bile acid (TBA), 84.0% (21/25) of patients with high-density lipoprotein cholesterol (HDL-C) . Fifty-nine anti-nuclear antibodies (ANA) were positive for autoantibodies (69%), of which 32 were nuclear membrane type and 20 were centromere type; 85 patients were positive for anti-mitochondrial antibody (AMA), of which 80 (94.1%) AMA M2 positive. Conclusion The PBC has no typical clinical symptoms, and doctors can obtain the diagnostic information through the clinical manifestations combined with the detection results of AMA, especially AMA M2.