Value of autoantibodies in predicting autoimmune liver disease
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摘要: 自身抗体作为自身免疫性肝病的诊断标志物已经在临床上得到了广泛应用,但其在病情严重程度及预后判断方面的价值报道并不多,事实上某些自身抗体除本身的诊断价值外,还具有预测病情的作用:如抗可溶性肝抗原抗体、抗肌动蛋白抗体、抗肝细胞溶质抗原Ⅰ型抗体、抗去唾液酸糖蛋白受体抗体、抗染色体抗体、抗环瓜氨酸多肽抗体和抗肝肾微粒体Ⅲ型抗体与自身免疫性肝炎的发生、发展及恶化有一定的相关性,其中抗可溶性肝抗原抗体与某些自身免疫性肝炎患者严重肝组织学改变、长期维持治疗、停药后再度恶化以及肝衰竭的发生相关;抗gp210抗体、抗Sp100抗体和抗着丝点抗体在原发性胆汁性肝硬化中有一定的预测意义,其中抗gp210抗体可提示原发性胆汁性肝硬化患者有较严重的界面性肝炎、小叶炎症以及易进展为肝衰竭等。Abstract: Autoantibodies have been widely used in autoimmune liver disease as diagnostic markers, but the value of estimating disease severity and prognosis has not been commonly comprehended.Actually, autoantibodies are valuable in predicting disease severity and treatment outcome as well as directing the diagnosis.Antibodies to soluble liver antigen, actin, liver cytosol type 1, asialoglycoprotein receptor, chromatin, cyclic citrullinated peptide, and uridine glucuronosyltransferases have been considered to be associated with the occurrence, severity and progression of autoimmune hepatitis.For example, antibody to soluble liver antigen is associated with severe histological changes, long durations of treatment, relapse after drug withdrawal and high frequency of liver failure.Besides, antibodies to Sp100, gp210 and centromere have prognostic value in primary biliary cirrhosis, for instance, antibody to gp210 is associated with severe interface hepatitis, lobular inflammation, and progression to liver failure.
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Key words:
- autoantibodies /
- hepatitis
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