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Analysis of serological characteristics in viral hepatitis patients with positive AMA-M2
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摘要:
目的探讨抗线粒体抗体M2亚型（AMA-M2）阳性的病毒性肝炎患者血清学指标的特征及其相应的临床意义。方法收集2011年1月至2013年12月于首都医科大学附属北京佑安医院就诊的病毒性肝炎患者血清,ELISA法检测其血清中的AMAM2浓度,共纳入101例AMA-M2阳性的病毒性肝炎患者,其中包括53例慢性乙型肝炎（CHB）患者、27例慢性丙型肝炎（CHC）患者、5例戊型肝炎（HE）患者、9例CHB合并原发性胆汁性肝硬化（PBC）患者、7例CHC合并PBC患者,同时收集60例PBC患者血清作为对照。将患者按疾病进行分组并结合临床血清学指标检测进行回顾性分析。计量资料组间比较采用单因素方差分析,进一步两两比较采用Dunnett-t检验。结果 CHB、CHC和HE组血清AMA-M2水平多为中低水平,显著低于PBC组及合并PBC组（P值均<0.000 1）;HE组血清ALT与AST水平高于PBC组（P值均<0.01）;CHB组和CHC组血清GGT水平均显著低于PBC组（P值均<0.001）,但与合并pbc的chb或chc患者相比,差异无统计学意义（p值均>0.05）;CH...
Abstract:Objective To explore the serological characteristics of viral hepatitis patients with positive anti- mitochondrial antibody( AMA)- M2 and its clinical implications. Methods Serum was collected from viral hepatitis patients who were admitted to Beijing You'an Hospital,Capital Medical University,from January 2011 to December 2013. Serum AMA- M2 was measured by ELISA. A total of 102 viral hepatitis patients with positive AMA- M2 were screened out,including 53 patients with chronic hepatitis B( CHB),27 patients with chronic hepatitis C( CHC),5 patients with hepatitis E( HE),9 patients with CHB accompanied by primary biliary cirrhosis( PBC),and 7 patients with CHC accompanied by PBC. We also collected serum from 60 PBC patients as controls. Patients were grouped by the clinical diagnosis and analyzed retrospectively considering their serological characteristics. Comparison of continuous data was made by one- way ANOVA. Results Level of serum AMA- M2 was low and medium in the CHB,CHC,and HE groups and was significantly lower than those of the PBC group and CHB / PBC and CHC / PBC groups( all P < 0. 0001). Serum ALT and AST in the HE group were significantly higher than that in the PBC group( P < 0. 01). Serum gamma- glutamyl transpeptidase( GGT) levels in the CHB and CHC groups were significantly lower than that in the PBC group( both P < 0. 001),but did not show significant difference when compared with the CHB / PBC or CHC / PBC group( P > 0. 05). Serum alkaline phosphatase( ALP) and Ig M in the CHB group were significantly lower than those in the PBC group( P< 0. 000 1). Serum ALP and Ig M in the CHC group were significantly lower than those in the PBC group and CHC / PBC group( all P <0. 05). Serum Ig M in the HE group was significantly lower that that in the PBC group( P < 0. 01). Serum C3 level in the CHB group was significantly lower than those in the PBC group and CHB / PBC group( both P < 0. 05). Conclusion AMA- M2 is not restricted to PBC patients alone,and medium or low level of AMA- M2 can be seen in patients with viral hepatitis,which is not an autoimmune disease. Other serological markers such as ALP,GGT,Ig M,and C3 are helpful in diagnosing and differentiating PBC.
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