抗Gp210阳性原发性胆汁性肝硬化患者临床特征

抗Gp210阳性原发性胆汁性肝硬化患者临床特征
邵幼林;张锁才;吴剑明;史罗明;马春明;周根法;郭风彩;郑剑
【期刊名称】《海南医学》
【年(卷),期】2016(027)005
【摘要】目的：探讨抗Gp210阳性原发性胆汁性肝硬化(PBC)患者的临床特征。

方法选取2009年至2012年在常州市第三人民医院免疫性肝病科初诊的122例PBC患者，按照抗Gp210阳性、抗Gp210和AMA-M2阳性、AMA-M2阳性将患者分为三组，分别为12例、31例和79例，比较三组患者间肝功能主要指标、血常规主要指标、Mayo危险评分和其他自身抗体的差异。

结果(1)三组患者的男/女构成分别为1/11、6/25、15/64，差异有显著统计学意义(P<0.01)；年龄分别为(56.42±11.29)岁、(57.00±12.14)岁、(54.81±11.60)岁,差异无统计学意义(P>0.05)；(2)三组患者的ALT[分别为(66.33±18.75) U/L、(82.65±69.53) U/L 和(119.01±152.68) U/L，P=0.23]、ALP [分别为(329.25±171.90) U/L、(347.68±240.83) U/L和(286.53±228.89) U/L，P=0.42]、TBil [分别为(40.42±29.63)µmol/L、(55.41±63.89)µmol/L和(52.05±94.34)µmol/L，
P=0.87]、ALB [分别为(34.98±5.51) g/L、(34.27±6.66) g/L和(36.63±5.71)
g/L，P=0.15]，CHOL [分别为(6.57±2.23) mmol/L、(4.39±2.25) mmol/L和(4.67±2.04) mmol/L，P=0.0090]比较，经统计学分析显示只有CHOL差异有统计学意义(P<0.05)；(3)三组患者的WBC [分别为(4.19±2.07)×109/L、
(4.51±2.10)×109/L和(4.66±1.98)×109/L，P=0.75]、Hb [分别为
(115.46±14.62) g/L、(107.07±23.49) g/L和(110.99±25.22) g/L，P=0.56]、PLT [分别为(129.33±85.63)×109/L、(120.27±87.57)×109/L和
(135.42±74.44)×109/L，P=0.66]比较，经统计学分析显示差异均无统计学意义(P>0.05)；(4)患者共检测到13种自身抗体：AMA-M2、抗Gp210、抗SP100、ANA、抗SSA、抗SSA-Ro52、ACA、抗SSB、抗Sm、抗核糖体P蛋白、单链DNA抗体、抗肝细胞胞浆抗体1型和抗肝肾微粒体抗体总阳性率依次为90.16%、35.25%、8.19%、63.93%、18.03%、13.93%、10.66%、3.28%、2.45%、
1.64%、1.64%、0.82%和0.82%，各抗体三组间比较差异均无统计学意义
(P>0.05)；(5) A、B、C三组患者Mayo危险评分分别为(5.80±1.39)分、
(6.22±1.77)分、(5.43±2.01)分，差异均无统计学意义(P>0.05)。

结论在横断面上，与含AMA-M2阳性PBC患者比较，抗Gp210阳性PBC患者性别和总胆固醇存
在差异。

%Objective To explore the characteristics of patients of primary biliary cirrhosis (PBC) with an-ti-Gp210 positive. Methods A total of 122 PBC patients who were treated in our hospital from 2009 to 2012 were en-rolled in the study, which were divided into three groups: group A of anti-Gp210(+), group B of anti-Gp210(+) and AMA-M2(+), group C of AMA-
M2(+), with 12, 31 and 79 patients in the three groups, respectively. The liver function indexes, blood routine indexes, Mayo risk score and other autoantibodies were compared between the three groups. Results (1) In
the three groups, the gender composition (male/female) was 1/11, 6/25,
15/64 in group A, group B, group C, with statistically significant difference (P<0.01), and the age was (56.42 ± 11.29), (57.00 ± 12.14), (54.81 ± 11.60) years old, with no statistically significant difference (P>0.05). (2) The differences between the three groups were not statistically significant in ALT [(66.33 ± 18.75) U/L, (82.65 ± 69.53) U/L, (119.01 ± 152.68) U/L,
P=0.23], ALP [(329.25 ± 171.90) U/L, (347.68 ± 240.83) U/L, (286.53 ±
228.89) U/L, P=0.42], TBil [(40.42 ± 29.63) µmol/L, (55.41 ± 63.89) µmol/L, (52.05 ± 94.34) µmol/L, P=0.87], and ALB [(34.98 ± 5.51) g/L, (34.27 ± 6.66) g/L, (36.63 ± 5.71) g/L,P=0.15], but significant in CHOL [(6.57±2.23) mmol/L, (4.39±2.25) mmol/L, (4.67±2.04) mmol/L, P=0.009 0]. (3) There was no statistically signif-icant difference between the three groups in WBC [(4.19±2.07)×109/L, (4.51±2.10)×109/L, (4.66±1.98)×109/L, P=0.75], Hb [(115.46 ± 14.62) g/L, (107.07 ± 23.49) g/L, (110.99 ± 25.22) g/L,
P=0.56], PLT [(129.33 ± 85.63) × 109/L, (120.27 ± 87.57)×109/L,
(135.42±74.44)×109/L, P=0.66]. (4) All patients were detected with 13 kinds of antibodies:AMA-M2, an-ti-Gp210, anti-SP100, ANA, anti-SSA, anti-SSA-Ro52, anti-SSB, anti-Sm, ACA, anti-ribosomal P protein, single strand-ed DNA antibody, anti liver cell cytoplasmic antibody of type 1 diabetes and liver kidney microsomal antibody, with the total positive rate of
90.16%, 35.25%, 8.19%, 63.93%, 18.03%, 13.93%, 10.66%, 3.28%, 2.45%, 1.64%, 1.64%, 0.82%and 0.82%, respectively. There was no significant difference among the three groups in each antibody. (5) The Mayo risk score were (5.80±1.39), (6.22±1.77), and (5.43±2.01) in the three groups, respectively with no statistically significant dif-ference between the three groups (P≥0.05). Conclusion On the transverse section, compared with AMA-M2 positive PBC patients, anti-Gp210 positive PBC patients showed significant differences in gender and total cholesterol.
【总页数】4页(P766-768,769)
【作者】邵幼林;张锁才;吴剑明;史罗明;马春明;周根法;郭风彩;郑剑
【作者单位】常州市第三人民医院免疫性肝病科，江苏常州 213001;常州市第三人民医院免疫性肝病科，江苏常州 213001;常州市第三人民医院免疫性肝病科，江苏常州 213001;常州市第三人民医院免疫性肝病科，江苏常州 213001;常州市第三人民医院免疫性肝病科，江苏常州 213001;常州市第三人民医院免疫性肝病科，江苏常州 213001;常州市第三人民医院免疫性肝病科，江苏常州 213001;常州市第三人民医院免疫性肝病科，江苏常州 213001
【正文语种】中文
【中图分类】R575.2
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