徐昕　朱珉之

[摘要] 目的 探討肝脏免疫学血清检测在原发性胆汁性肝硬化诊断中的临床意义。 方法 按照不同疾病分类，选取2017年6月至2019年7月我院收治的40例PBC患者为研究组，另选择慢性病毒性肝炎40例为对照组，所选患者均做血清免疫学及肝功能检测，并对所选患者的肝纤四项、血清免疫球蛋白等临床意义进行分析。 结果 研究组PBC患者的平均年龄、性别及并发症与对照组比较，差异无统计学意义（P>0.05）。经血清免疫学原发性胆汁性肝硬化及肝功能指标情况分析，研究组的ALT、IgM、Ⅳ-c、HA、PCⅢ明显高于对照组，差异有统计学意义（P<0.05）;而AST、IgA、IgG、LN两组比较，差异无统计学意义（P>0.05）。 结论 探讨肝脏免疫学血清检测在PBC鉴别诊断中的临床意义，对患者早期风险评估及预后诊断有着重要的临床参考价值，值得进一步推广。

[关键词] 原发性胆汁性肝硬化;免疫球蛋白;肝功能;肝纤四项

[中图分类号] R446          [文献标识码] B          [文章编号] 1673-9701（2021）04-0119-03

Clinical significance of serum immunological detection in the diagnosis of Primary biliary cirrhosis

XU Xin   ZHU Minzhi

Department of Clinical Laboratory，Changzhou Third People′s Hospital in Jiangsu Province， Changzhou   213000， China

[Abstract] Objective To explore the clinical significance of serum hepatic immunological detection in the diagnosis of primary biliary cirrhosis （PBC）. Methods Patients with PBC admitted to our hospital from June 2017 to July 2019 were selected as the study group （n=40）， while patients with chronic viral hepatitis were selected as the control group（n=40） according to the different disease classifications. Serum immunological and hepatic function detection were performed in all selected patients， and the clinical significance of four indexes of hepatic fibrosis and serum immunoglobulin，etc.were analyzed. Results The average age， gender and complications of PBC patients in the study group were not significantly different from those in the control group， and none of the differences were statistically significant（P>0.05）. After the patients′serum immunological detections were performed and the hepatic function indexes were analyzed， ALT， IgM， Ⅳ-c， HA and PCⅢ in the study group were significantly higher than those in the control group， and the differences were all statistically significant（P<0.05）. However， there was no significant differences in AST， IgA， IgG and LN between the two groups. Meanwhile，the differences were not statistically significant（P>0.05）. Conclusion The investigation of the clinical significance of serum hepatic immunological detection in differential diagnosis of PBC， which has vital clinical reference value for early risk assessment and prognosis diagnosis of patients and is worthy of further promotion.

[Key words] Primary biliary cirrhosis; Immunoglobulin; Hepatic function; Four indexes of hepatic fibrosis

原发性胆汁性肝硬化（Primary biliary cirrhosis，PBC）是一种累及肝脏小胆管的慢性非化脓性炎症。其病因尚未明确，一般认为是一种自身免疫性疾病[1]。其发病机制与免疫、环境、遗传易感性、感染和化学物质等因素有关，其临床表现缺乏特异性，目前已知它可表现为无任何症状的征象，或表现为慢性或急性发作，也可表现为爆发性发作[2]。原发性胆汁性肝硬化的临床表现为疲劳和肌肉酸痛，急性黄疸性需与急性病毒性肝炎鉴别，可通过检测血清免疫球蛋白水平来鑒别，前者血清免疫球蛋白水平明显升高[3]。临床上一般以临床症状及血清中出现特异的自身抗体为依据对自身免疫性肝病进行分型。由于……