| Research purpose:To observe the expression and distribution of autoantibodies in serum of patients with chronic liver disease,and to explore the mechanism and clinical significance of immune mechanism in the development of chronic liver disease.Methods:We collected 228 patients with chronic liver disease diagnosed from September 2016 to September 2019 in our hospital,and we divided into four groups:78 cases with chronic viral hepatitis,including 53 cases with hepatitis B and 25 cases with hepatitis C,61 patients with alcoholic liver disease,42 cases of drug-induced liver injury and 47 cases of autoimmune liver disease,in addition,we select 25 cases of healthy people as normal control group.All patients were tested with a series of autoimmune antibodies including ANA,AMA/AMA-M2,SMA,LC-1,LKM-1,PML,Ro52,gp210 and sp100.We observed and recorded the sex and age of patients,the expression and distribution of autoantibodies.Results:1.Among the 228 patients with chronic liver disease selected in this study,the autoantibody positive rates of autoimmune liver disease,viral hepatitis,drug-induced liver injury and alcoholic liver disease were 91.49%,46.15%,71.43% and 67.21%.2.Among the 47 patients with autoimmune liver disease,there were 5 cases of autoimmune hepatitis,39 cases of primary biliary cholangitis and 3 cases of primary sclerosing cholangitis.The positive rates of autoantibodies in the 3 groups were 80.00%,97.44% and 33.3%.The ANA detection rate of AIH group was the highest(80%),followed by Ro52,SMA and LC-1(60.00%,40.00% and 10.00%).Seven autoantibodies were detected in the PBC group,among which the highest positive rate was AMA/ AMA-M2(97.44%).ANA was detected in 1 patient in the PSC group.3.There were 78 cases of chronic viral hepatitis,including 53 cases of hepatitis B and 25 cases of hepatitis C.A total of 7 autoantibodies were detected for hepatitis B,including ANA,AMA/ AMA-M2,PML,Ro52,gp210,sp100 and LKM-1,with positive rates of 35.85%,9.43%,3.77%,7.55%,5.66%,1.89% and 1.89%,respectively.A total of 4 kinds of antibodies were detected in hepatitis C,with the highest detection rate of ANA(48.00%),followed by Ro52,AMA/ AMA-M2 and PML(24.00%,4.00% and 4.00%).The positive detection rate of autoantibody for hepatitis C was 56.00% higher than that for hepatitis B(41.51%),but the results were not statistically significant.4.There were 61 patients with alcoholic liver disease,including 24 in the nonalcoholic cirrhosis group and 37 in the alcoholic cirrhosis group.Two autoantibodies,ANA and AMA/ AMA-M2,were detected in patients with non-alcoholic cirrhosis,with positive rates of 45.83% and 12.50%,respectively.Six autoantibodies,including ANA,AMA/AMA-M2,PML,Ro52,gp210 and LC-1,were detected in patients with alcoholic cirrhosis,with positive rates of 75.68%,5.41%,8.11%,8.11%,8.11%,and 2.70%.The total positive rates of serum autoantibodies in the two groups were 45.83% and 81.08%,with statistically significant differences(P<0.05).5.Among the 42 patients with drug-induced liver injury,there are 15 hepatocyte injury type,18 cholestasis type and 9 mixed type.Six kinds of autoantibodies were detected for hepatocyte type,including ANA,AMA/ AMA-M2,PML,Ro52,gp210 and LC-1,with positive rates of 60.00%,13.33%,6.67%,20.00%,13.33% and 6.67%.Six kinds of autoantibodies can be detected for cholestasis type,namely ANA,AMA/ AMA-M2,Ro52,gp210,LC-1 and LKM-1,with positive rates of 72.22%,5.56%,27.78%,11.11%,11.11% and 5.56%.Four autoantibodies,ANA,AMA/ AMA-M2,Ro52 and gp210,were detected in the mixed group,with positive rates of 33.33%,11.11%,22.22% and 11.11%.The total positive rates of autoantibodies against druginduced liver disease in the three groups were 73.33%,83.33% and 44.44%,respectively.The cholestatic type was slightly higher than hepatocyte type and mixed type,with no significant difference(P<0.05).Conclusion:1.The overall distribution of autoantibodies in patients with chronic liver disease was 91.49% for autoimmune liver disease,46.15% for viral hepatitis,71.43% for drug-induced liver injury,and 67.21% for alcoholic liver disease.2.The distribution of different types of autoantibodies in patients with different types of chronic liver disease showed the highest ANA positive expression rate;AIH followed by Ro52 and SMA;Drug-induced liver injury has relatively high expression of Ro52 and gp210;PML,Ro52 and gp210 were mostly expressed in patients with alcoholic cirrhosis.In viral hepatitis,Ro52 and AMA/ AMA-M2 were relatively higher.3.In patients with chronic liver disease have different kinds of different level detection of autoantibodies,suggests that chronic liver disease caused directly the have the cause of liver cell damage,there are different levels of immune injury mechanism,although illustrates the clinical etiology,has been removed disease progress,even to the possibility of liver cirrhosis or liver cancer,for the follow-up of chronic liver disease and monitoring provides a theoretical basis. |
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