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目的:原发性胆汁性肝硬化(PBC)与自身免疫性肝炎(AIH)的临床表现存在相似性,因而不易鉴别及诊断。本研究对免疫球蛋白在PBC和AIH中的表达情况进行比较并分析其意义,为两种疾病的鉴别和诊断积累临床资料。方法:选取2011年10月-2012年10月在我院接受治疗的原发性胆汁性肝硬化患者20例作为PBC组,另选取20例同期入院治疗的自身免疫性肝炎患者作为AIH组。利用免疫组化法检测两组患者病变组织中免疫球蛋白IgM和IgG的表达水平,比较两组细胞的阳性表达率,并对阳性细胞含量进行评分。结果:PBC组:17例患者显示IgM阳性(85%),3例患者显示IgG阳性(15%),IgM与IgG比值>1,IgM评分为3.2±0.8,IgG评分为1.5±0.6;AIH组:18例患者显示IgG阳性(90%),2例患者显示IgM阳性(10%),IgM与IgG比值<1,IgM评分为1.2±0.7,IgG评分为2.4±0.9。PBC组的IgM评分明显高于AIH组,而AIH组的IgG评分则明显高于PBC组,差异具有统计学意义(P<0.05)。结论:检测IgG和IgM的表达水平对原发性胆汁性肝硬化与自身免疫性肝炎的临床诊断具有较高的敏感性和特异性,可作为鉴别两种疾病的依据之一,值得进一步推广应用。
OBJECTIVE: There are similar clinical manifestations of primary biliary cirrhosis (PBC) and autoimmune hepatitis (AIH), so it is not easy to identify and diagnose. In this study, the expression of immunoglobulin in PBC and AIH was compared and analyzed, and the clinical data were accumulated for the identification and diagnosis of the two diseases. Methods: Twenty patients with primary biliary cirrhosis who were treated in our hospital from October 2011 to October 2012 were selected as the PBC group. Twenty patients with autoimmune hepatitis were enrolled as the AIH group. Immunohistochemistry was used to detect the expression of immunoglobulin IgM and IgG in the diseased tissues of both groups. The positive expression rates of the two groups of cells were compared, and the positive cells were scored. Results: In the PBC group, IgM was positive (85%) in 17 patients, IgG positive in 15 patients (15%), IgM to IgG was> 1, IgM was 3.2 ± 0.8 and IgG was 1.5 ± 0.6 in AIH group : 18 were positive for IgG (90%), 2 were positive for IgM (10%), IgM to IgG was <1, IgM was 1.2 ± 0.7 and IgG was 2.4 ± 0.9. The IgM score of PBC group was significantly higher than that of AIH group, while the IgG score of AIH group was significantly higher than that of PBC group (P <0.05). Conclusion: The detection of IgG and IgM expression levels of the clinical diagnosis of primary biliary cirrhosis and autoimmune hepatitis with high sensitivity and specificity, can be used as a basis for identification of two diseases, it is worth further promotion .