针对慢性肝病患者我们会经常检测到自身抗体；然而自身抗体在酒精性肝病中的阳性率还不确定。这项研究的目的就是为了评估酒精性肝病自身抗体的阳性率和意义。我们纳入了90例患者，这些患者患有酒精性肝病或者酒精性肝病合并慢性乙型肝炎。我们对他们的临床数据和实验室检查进行了回顾性分析。通过间接免疫荧光法检测抗核抗体（ANA），抗线粒体抗体（AMA）和抗平滑肌抗体（SMA）。自身抗体在酒精性肝病的患者中阳性率为69.6%，在酒精性肝病合并慢性乙型肝炎的患者中为66.7%。总的抗核抗体在酒精性肝病患者中的阳性率为63.8%。高滴度的自身抗体以及多种自身抗体在病情已进展至肝硬化的患者中更常见。自身抗体阳性组与阴性组在球蛋白、白细胞及血小板水平上有显著差异。而其他的实验室参数两组之间是相似的；此外，酒精性肝病患者比单纯慢性乙型肝炎患者自身抗体阳性率要高。最终，10.4%自身抗体阳性的酒精性肝病患有自身免疫性疾病或者血管性疾病，这在慢性乙型肝炎患者中是没有的。自身抗体常常在酒精性肝病患者中出现，这些自身抗体往往与肝病进展相关。酒精性肝病患者的自身抗体阳性率越高预示着与酒精相关的免疫学紊乱参与了病情进展。
吉林大学第一医院肝病科 祁亚宾 摘译
本文首次发表于[消化病杂志，2013年5月]
The prevalence and significance of autoantibodies in patients with alcoholic liver disease.
OBJECTIVE Autoantibodies have frequently been identified in chronic liver diseases. However, the prevalence of autoantibodies in alcoholic liver disease (ALD) is uncertain. The aim of this study was to evaluate the prevalence and significance of autoantibodies in patients with ALD.
METHODS A total of 90 male patients diagnosed as ALD or ALD overlapped with chronic hepatitis B (CHB) were included and retrospectively[,retrəu'spektiv] analyzed. Clinical data and laboratory findings were collected. Anti-nuclear antibodies (ANA), antimitochondrial antibodies (AMA) and anti-smooth muscle antibodies (SMA) were detected by indirect immunofluorescent assay.
RESULTS Autoantibodies were found in 69.6% (48/69) patients with ALD and 66.7% (14/21) patients with ALD overlapped with CHB. The prevalence of total ANA in patients with ALD was 63.8% (44/69). High titers of autoantibodies and multi-autoantibodies were found more often associated with cirrhosis. There was a significantly difference in the values of globulin (P<0.05),white blood cells (P<0.05) and platelet count (P<0.05) between the patients with positive autoantibodies and the negative ones. However, the values of other parameters were similar between two groups. Moreover, patients with ALD had more frequently autoantibodies positive than patients with CHB alone (69.6% vs 37.5%, p<0.01). Finally, 10.4% of ALD patients with positive autoantibodies had systemic autoimmune diseases or vascular diseases, which was not found in the CHB patients.
CONCLUSIONSAutoantibodies are frequently present in patients with ALD, which is correlated with advancedliver disease. High prevenlence of autoantibodies in ALD may indicate that alcoholic associated immune disturbance occurr during the development of disease.
