上海地区体检者中筛查M2型抗线粒体抗体的阳性率分析

doi:10.3969/j.issn.1673-8640.2015.03.002

摘要/Abstract

摘要： 目的

通过分析成年体检者M2型抗线粒体抗体(AMA-M2)的阳性率情况,评价AMA-M2对原发性胆汁性肝硬化(PBC)早期筛查的价值。

方法

收集健康体检人群血清样本6 658例,其中男3 845例,女2 813例,男女比例为1.37∶1,年龄(46±13)岁。采用酶联免疫吸附试验(ELISA)定量检测AMA-M2,并与血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)和γ-谷氨酰基转移酶(GGT)检测结果同时分析。

结果

在6 658名健康体检者中AMA-M2阳性97例(1.46%),其中男性和女性分别为44例(1.14%)和53例(1.88%),男女之比为1∶1.2;≥46岁的女性AMA-M2阳性率高于<46岁的女性(P<0.01),97例AMA-M2阳性且无任何疾病包括PBC相关临床症状者中有8例伴ALP升高,GGT也升高。

结论

对健康体检者应高度重视AMA-M2与ALP/GGT甚至ALT与AST的关联分析,AMA-M2筛查是高危人群早期发现PBC的有效途径,按照美国肝脏病学会(AASLD)PBC诊疗指南的诊断标准监测AMA-M2阳性体检者的 AMA-M2和肝脏血清酶水平有助于提高PBC的早诊率。

关键词: M2型抗线粒体抗体, 原发性胆汁性肝硬化, 健康体检, 阳性率, 自身免疫性疾病

Abstract: Objective

To investigate the early screening significance of M2 anti-mitochondrial antibodies(AMA-M2) for primary biliary cirrhosis(PBC) in physical examine, through analyzing the positive rate of AMA-M2.

Methods

Serum samples were collected from 6 658 healthy subjects(3 845 males and 2 813 females), and the sex ratio was 1.37∶1. Their age was 46±13. AMA-M2 was quantitatively determined by enzyme-linked immunosorbent assay(ELISA). Serum alanine aminotransferase(ALT), aspartate aminotransferase(AST), alkaline phosphatase(ALP) and gamma glutamyltransferase (GGT) were determined, and the results were analyzed cemparatively.

Results

AMA-M2 were detected in 97 of 6 658 healthy subjects(1.46%), including 44 males (1.14%) and 53 females(1.88%), and the sex ratio was 1∶1.2. AMA-M2 positive rate of females above 46 years old was higher than those below 46 years old (P<0.01). The 8 of 97 AMA-M2 positive cases without PBC clinical feature had increasing ALP and GGT.

Conclusions

Physical examination should pay attention to the correlation analysis of AMA-M2 with ALP/GGT and ALT with AST. AMA-M2 screening is an effective mean to high risk population in the early detection of PBC. According to American Association for the Study of Liver Disease (AASLD) PBC liver disease diagnostic criteria, positive AMA-M2 and serum liver enzyme help with improving the early detection rate of PBC.

Key words: M2 anti-mitochondrial antibody, Primary biliary cirrhosis, Physical examination, Positive rate, Autoimmunity disease

中图分类号:

R446.1

蔡逸婷, 黄盛, 谢松业. 上海地区体检者中筛查M2型抗线粒体抗体的阳性率分析[J]. 检验医学, 2015, 30(3): 214-218.

CAI Yiting, HUANG Sheng, XIE Songye. Analysis on the positive rate of M2 anti-mitochondrial antibodies in physical examine screening in Shanghai[J]. Laboratory Medicine, 2015, 30(3): 214-218.

图/表 3

参考文献 15

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年龄(岁)	例数	男性		女性		阳性数合计(%)
年龄(岁)	例数	例数	阳性数(%)	例数	阳性数(%)	阳性数合计(%)
16~45	3 203	1 746	20(1.15)	1 457	17(1.17)	37(1.16)
46~55	1 769	1 028	10(0.97)	741	16(2.16)	26(1.46)
56~65	1 316	852	11(1.29)	464	14(3.02)	25(1.90)
66~75	273	168	3(1.78)	105	4(3.81)	7(2.57)
>75	97	51	0(0.00)	46	2(4.35)	2(2.06)
合计	6 658	3 845	44(1.14)	2 813	53(1.88)	97(1.46)

年龄(岁)	例数	男性		女性		阳性数合计(%)
年龄(岁)	例数	例数	阳性数(%)	例数	阳性数(%)	阳性数合计(%)
16~45	3 203	1 746	20(1.15)	1 457	17(1.17)	37(1.16)
46~55	1 769	1 028	10(0.97)	741	16(2.16)	26(1.46)
56~65	1 316	852	11(1.29)	464	14(3.02)	25(1.90)
66~75	273	168	3(1.78)	105	4(3.81)	7(2.57)
>75	97	51	0(0.00)	46	2(4.35)	2(2.06)
合计	6 658	3 845	44(1.14)	2 813	53(1.88)	97(1.46)

受检者	性别	年龄(岁)	AMA-M2(RU/mL)	ALP(IU/L)	GGT(IU/L)	ALT(IU/L)	AST(IU/L)
1	女	58	>800	515	436	44	106
2	女	41	>800	132	155	27	35
3	女	66	608	150	119	15	24
4	女	54	608	215	491	51	70
5	女	50	161	453	465	28	62
6	女	79	158	186	192	15	33
7	女	75	50	247	144	65	81
8	男	42	38	240	105	111	302

受检者	性别	年龄(岁)	AMA-M2(RU/mL)	ALP(IU/L)	GGT(IU/L)	ALT(IU/L)	AST(IU/L)
1	女	58	>800	515	436	44	106
2	女	41	>800	132	155	27	35
3	女	66	608	150	119	15	24
4	女	54	608	215	491	51	70
5	女	50	161	453	465	28	62
6	女	79	158	186	192	15	33
7	女	75	50	247	144	65	81
8	男	42	38	240	105	111	302

组别	例数	ALP		GGT		ALT		AST
组别	例数	浓度 (IU/L)	阳性数 (%)	浓度 (IU/L)	阳性数 (%)	浓度 (IU/L)	阳性数 (%)	浓度 (IU/L)	阳性数 (%)
AMA-M2低浓度组	62	55.0 (45.0,71.5)	2 (3.22)	22.0 (15.0,41.0)	12 (19.35)	10.0 (7.0,16.8)	2 (3.22)	18.0 (15.0,24.0)	2 (3.22)
AMA-M2高浓度组	35	77.0 (56.0,122.0)	6 (17.14)	52.0 (22.0,139.0)	18 (51.43)	15.0 (12.0,27.0)	6 (17.14)	24.0 (19.0,31.2)	6 (17.14)