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目的:探讨自身抗体和各项生化指标在自身免疫性肝炎诊断中的意义。方法:对109例患者采用间接免疫荧光法及免疫印迹法进行自身抗体(ANA、SMA、LKM-1、LC-1、SLA/LP)的检测,结合其生化指标(ALT、AST、GGT、ALP、TBA)进行分析。并将109例患者按国际评分标准计算的积分以>15分组和?15分组两组,进行积分、血清抗体和诊断的相关性分析。结果:109例ANA抗体异常患者中AIH23例,其中血清抗体阳性的患者有20例,血清抗体诊断AIH的灵敏度为87%,特异度为86.7%,诊断AIH的阳性预测值为73.5%。疾病组的生化指标ALT,AST,GGT,TBA与对照组比较差别有统计学意义(P<0.05),并以其为自变量,AIH为因变量进行Logistic回归统计,入选的是ALP和GGT。血清抗体与诊断的相关性分析表明呈正相关(r=0.237,P<0.05),积分与诊断也呈正相关(r=0.745,P<0.01)。结论:自身抗体在AIH的诊断中有较高特异性。生化指标ALT,AST,TBA在AIH组中有明显降低,而GGT明显升高。在AIH的诊断中有一定的临床意义。
Objective: To explore the significance of autoantibodies and biochemical markers in the diagnosis of autoimmune hepatitis. Methods: 109 patients were tested for their autoantibodies (ANA, SMA, LKM-1, LC-1, SLA / LP) by indirect immunofluorescence and immunoblotting. Combined with their biochemical parameters (ALT, AST, GGT, ALP , TBA) for analysis. And 109 patients according to the international score standard points in> 15 and 15 groups of two points, integration, serum antibody and diagnostic correlation analysis. Results: There were 23 cases of AIH in 109 patients with abnormal ANA antibody, of which 20 cases were positive for serum antibody. The sensitivity and specificity of serum antibody for diagnosing AIH were 87% and 86.7%, respectively. The positive predictive value of diagnosing AIH was 73.5%. The biochemical indexes ALT, AST, GGT and TBA in the disease group were significantly different from those in the control group (P <0.05). Logistic regression was used to determine the biochemical parameters of ALT, AST and ALP as the dependent variables. ALP and GGT were selected. Correlation analysis of serum antibody and diagnosis showed a positive correlation (r = 0.237, P <0.05), and the score was also positively correlated with the diagnosis (r = 0.745, P <0.01). Conclusion: Autoantibodies have high specificity in the diagnosis of AIH. Biochemical indicators ALT, AST, TBA in the AIH group was significantly lower, while the GGT was significantly higher. In the diagnosis of AIH has some clinical significance.