Discussion About Serum AMA-M2 In Chronic Cholestatic Liver Disease Patients And In PEG Interferon Antivirological Treatment

Object:To analysis of serum AMA-M2 with the exception of viral hepatitis in Cholestasis of clinical significance and Peg-IFN antiviral treatment of chronic viral hepatitis in the importance of AMA-M2 antibodies.Method:From January 2005 on the Jilin University in China and Japan uion hospital digestive disease of merge Cholestasis of 176 cases in patients with chronic liver disease (68 male, 108 female, age 23 ~ 75-year-old, the average age of 53.3±15.4-year-old) and to interferon treatment of CHB and CHC patients with 487 (167 male, 32 female, cases of 15 ~ 70 years, the average age of 56.7±17.3-year-old), diagnostic criterion-referenced 2009 American Liver Disease Association diagnostic criteria formulated by the PBC. Using immuno-fluorescence and ELISA assay autoimmune hepatitis antibodies; using Beckman automatic detect serum biochemical parametersResults:Serum AMA-M2-positive subjects 91 cases (40.4%). On 94 cases PBC patients in the male: female ratio was 1: 8; it was mainly 40-59-year-old female; more than half of the patients were fatigue, pruritus, jaundice, one of the most common fatigue performers. 89.6% of patients with serum biochemistry exception, ALP,γ-GT,TBIL elevated often obvious, > 2 x ULN,at the same time with other related antibodies-positive. Treatment with UDCA pruritus, jaundice, remission rate has gradually increased. The treatment process with the treatment of prolonged, Child-Pugh B-level with significantly reduced (P<0.01), Child-Pugh A-level in a significant increase (P<0.01), While the number of patients with Child-Pugh C-level no obvious change (P> 0.05),For long-term use of Peg-IFN treatment of 213 cases of CVH (including CHC 121 cases, CHB 92 cases) AMA-M2 antibodies of long-term monitoring, the results were displayed with the treatment time, patients with CHC positive rate and Sera AMA-M2 antibody titer of significant increase (P<0.05), and PBC persons treatment process fatigue, pruritus, jaundice which PBC related symptoms gradually increased (P<0.05), And HCV-RNA undeterminable, related symptoms persistsDiscussion: PBC is small and medium-sized intrahepatic bile duct slowly progressive non-purulent inflammation due to chronic cholestatic diseases. serum AMA-M2 is PBC specific antibodies, the diagnosis of the PBC was important. In the event of serum AMA-M2 antibody positive, the vast majority of patients in 10-30 years progress to liver cirrhosis, the fatality rate in cirrhosis 0.6%-2%. As serum antibodies to AMA and its subtypes, such as autoantibodies in extensive and PBC of clinical pathology, diagnosis of PBC rate substantially rise. Serum AMA-M2 antibodies in patients with chronic liver disease diagnosis and PBC of become hot issues.This group, with the exception of viral hepatitis, alcoholic and non-alcoholic fatty liver disease and drug-induced liver disease of merge Cholestasis of 176 cases of chronic hepatitis AMA-M2 antibody-positive rate of 34.1%, hint analysis of serum AMA-M2 antibodies on unexplained cholestatic patient diagnosis is important. The aim of the PBC patients is most common in middle-aged women; to fatigue, pruritus, jaundice symptoms; to ALP,γ-GT, TBIL rise to biochemical characteristics. Some patients may appear at the ANA, SMA, LKM1 antibodies. UDCA is the most effective treatment of PBC. Where 15mg/(kg·day) to 10mg/(kg·day), the treatment process with the treatment of prolonged, Child-Pugh classification significantly alter, prompting early treatment can significantly improve UDCA Child-Pugh classification, whether increasing the dose treatment better and need further study. On the long-term application of Peg-IFN antivirus 213 cases of CVH (including CHC 121 cases and CHB 92 case) AMA-M2 antibodies tracking monitoring, the results appear as treatment time, patients with CHC antibodies in Sera AMA-M2 positive rate significantly increased; CHC patients with PBC treatment process fatigue, pruritus, jaundice which PBC related symptoms gradually increased, and HCV-RNA undeterminable, related symptoms persists. Tip long-term application Peg-IFN the antiviral treatment of chronic viral hepatitis, particularly chronic hepatitis c can be evoked potential merger of PBC patients serum antibodies to AMA-M2 and consequent clinical symptoms.Conclusion: This group, with the exception of viral hepatitis, alcoholic and non-alcoholic fatty liver disease and drug-induced liver disease of merge Cholestasis of involvement AMA-M2 antibody positive rate of 34.1%, prompt analysis of serum AMA-M2 antibodies on unexplained cholestatic patients diagnosis was critical. The aim of the PBC patients is most common in middle-aged women; to fatigue, pruritus, jaundice symptoms; to ALP,γ-GT, TBIL rise to biochemical characteristics. Some patients could appear at the ANA, SMA, LKM1 antibodies. UDCA was the most effective treatment of PBC. Where 15mg/(kg·day) to 10mg/(kg·day). Early application of UDCA therapy could significantly improve Child-Pugh classification. Long-term use of Peg-IFN of antiviral treatment of chronic viral hepatitis, particularly CHC can be evoked potential merger of PBC patients serum antibodies to AMA-M2 and consequent clinical symptoms.