摘要
目的在健康体检者中检测原发性胆汁性肝硬化(PBC)特异性抗M2型线粒体抗体(AMAM2),对阳性者的各项检测结果进行分析,评价AMA-M2对PBC早期筛查的价值。方法应用酶联免疫吸附试验(ELISA)检测36 459名健康体检者的AMA-M2水平,进一步分析AMA-M2阳性者的生化指标,采用影像学检查排除非PBC异常,进行诊断。结果在36 459例受检样本中共检出AMA-M2阳性438例,阳性率为1.20%。在男性受检者中,AMA-M2阳性者占0.72%(135/18 687);在女性受检者中,AMA-M2阳性者占1.70%(303/17 772)。在438例AMA-M2阳性者中有39例碱性磷酸酶(ALP)升高,3例γ-谷氨酰基转移酶(GGT)升高,15例丙氨酸氨基转移酶(ALT)升高,7例总胆红素(TB)、7例直接胆红素(DBil)和4例间接胆红素(IBil)升高。综合生化检测及AMA-M2结果共有39例受检者符合PBC诊断标准(患病率为0.11%),其中男性受检者10例,年龄(59.40±13.93)岁,女性受检者29例,年龄(54.31±14.80)岁。结论贵阳地区无症状PBC患者并不少见,在健康人群中开展AMA-M2检测是早期发现PBC的有效途径。
Objective To screen specific anti-mitochondrial antibody(AMA)-M2 for primary biliary cirrhosis(PBC) in healthy subjects,to analyze the results of positive cases,and to evaluate the role of AMA-M2 for the early screening of PBC. Methods AMA-M2 in 36 459 healthy subjects were determined by enzyme-linked immunosorbent assay(ELISA). The results of AMA-M2 positive cases were analyzed further. Imaging examination was used to exclude non-PBC abnormality and make diagnosis. Results A total of 438 AMA-M2 positive cases were determined. The positive rate was 1.20%. There were 0.72% males(135/18 687)and 1.70% females(303/17 772). In the 438 AMA-M2 positive cases,39 cases had alkaline phosphatase(ALP) increasing,3 cases with gamma-glutamyltransferase(GGT) increasing,15 cases with alanine aminotransferase(ALT)increasing,7 cases with total bilirubin(TB) increasing,7 cases with direct bilirubin(DBil) increasing and 4 cases with indirect bilirubin(IBil)increasing. Combined with the results of biochemical determinations,there were 39 cases meeting the diagnostic criteria of PBC. The prevalence rate was 0.11%,in which 10 males were(59.40±13.93)years old and 29 females were(54.31±14.80) years old. Conclusions Asymptomatic patients with PBC are common in Guiyang. Carrying out AMA-M2 screening in healthy population is an effective approach for the early determination of PBC.
引文
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