原发性胆汁性胆管炎的实验室诊断

doi:10.3877/cma.j.issn.2095-5820.2017.04.002

中华临床实验室管理电子杂志 ›› 2017, Vol. 05 ›› Issue (04) : 197 -199. doi: 10.3877/cma.j.issn.2095-5820.2017.04.002

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原发性胆汁性胆管炎的实验室诊断

王春霞¹^,^†(

), 王佳佳¹

^1. 250101　济南金域医学检验中心自身免疫病诊断中心

收稿日期:2017-09-17 出版日期:2017-11-28
通信作者: 王春霞
基金资助:
山东省泰山产业领军人才项目(tscy20150403)

Laboratory diagnosis of primary biliary cholangitis

Chunxia Wang¹^,^†(), Jiajia Wang¹

^1. Autoimmune Disease Diagnostic Center, Jinan Kingmed Diagonostics, Jinan 250101, China

Received:2017-09-17 Published:2017-11-28
Corresponding author: Chunxia Wang
About author:
Corresponding author: Wang Chunxia, Email: zb-wangchunxia@kingmed.com.cn

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原发性胆汁性胆管炎(primary biliary cholangitis, PBC)是最常见的自身免疫性肝病，起病隐匿、病程迁延、误诊率高、危害大。90%以上的PBC患者血清中存在特异性的抗线粒体抗体(antimitochondrial autoantibody, AMA)，而抗核膜糖蛋白抗体(anti- glycoprotein 210 antibody，gp210)和抗可溶性酸性核蛋白抗体(nuclear autoantigen Sp 100 antibody, Sp100)检测的阳性率虽然不高，但都是PBC的特异性抗体，尤其对AMA抗体阴性的PBC患者诊断价值较大，且与疾病严重程度相关。由于AMA抗体在患者发病前数年就可以在血液中出现，早期筛查AMA-M2抗体，早期诊断无症状期的PBC，并进行有效干预和治疗，对延缓疾病进程，提高患者生活质量，减轻社会和家庭经济负担，意义重大。

关键词: 自身免疫性肝病, 原发性胆汁性胆管炎, 抗线粒体抗体

Primary biliary cholangitis (PBC) is the most common disease among autoimmune liver diseases. PBC is a chronic cholestatic disease with a progressive course which may extend over many decades. The disease offten has insidious onset and is quite often misdiagnosed or results in a prolonged course. Antimitochondrial autoantibodies (AMA) are the classical specific serological marker of PBC and are found in 90% to 95% of PBC patients. Antibodies to glycoprotein 210 (gp210) and nuclear autoantigen Sp 100 (sp100) are specific for PBC but with low sensitivity. They are more useful for dignosising AMA-negative PBC. An association between anti-gp210 antibodies and disease severity has been reported. AMA may be detectable in serum when patients are symptom-free and liver function tests are normal. Screening the patients during the early stage of the disease process, can influence the clinical phenotype, and long-term prognosis of PBC, and improve the quality of patient′s life.

Key words: Autoimmune liver diseases, Primary biliary cholangitis, Antimitochondrial autoantibody

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