中文摘要：

目的 探讨抗线粒体抗体M2亚型（AMA-M2）在原发性胆汁性肝硬化（PBC）及非PBC患者中的特点. 方法 应用间接免疫荧光法及酶联免疫吸附法检测2011年1月至2013年12月在我院就诊的肝功能异常患者血清中的抗核抗体（ANA）、AMA及AMA-M2,对检测结果及临床资料进行回顾性分析.计数资料以例和百分比描述,采用x2检验和单因素方差分析.结果 5315例肝功能异常患者中,AMA-M2阳性占15.3％ （811/5 315）.AMA-M2阳性患者中78.4％ （636/811）的患者确诊为PBC,4.4％（36/811）的患者确诊为PBC/自身免疫性肝炎（AIH）重叠综合征,4.4％（36/811）的患者确诊为药物性肝损伤,6.5％（53/811）的患者确诊为慢性乙型肝炎（CHB）,3.3％（27/811）患者确诊为慢性丙型肝炎（CHC）,0.6％（5/811）的患者确诊为戊型肝炎,0.9％（7/811）的患者确诊为酒精性肝病,0.5％（4/811）的患者确诊为非酒精性脂肪性肝病,0.8％（6/811）的患者确诊为原发性肝癌,0.1％（1/811）的患者确诊为传染性单核细胞增多症.AMA-M2水平在PBC组与PBC/AIH重叠综合征组比较,P＞ 0.05,差异无统计学意义;但显著高于其他各组,P值均＜0.001,差异均有统计学意义.811例AMA-M2阳性患者中,AMA阳性占88.5％ （718/811）,ANA阳性占91.1％ （739/811）.PBC组的ALT、AST水平分别为（96.02±115.56）U/L和（94.82±83.32） U/L,显著低于药物性肝损伤组的（527.74±684.65） U/L、（490.60±716.89） U/L和戊型肝炎组的（1015.94±165.55） U/L、（665.4±297.14） U/L,F值分别为8.041、8.066,P值均＜0.05,差异均有统计学意义.PBC组的碱性磷酸酶、γ-谷氨酰转移酶水平分别为（265.16±179.08） U/L、（332.02±279.29） U/L,明显高于CHB组的（135.35±123.17）U/L、（140.27±229.24）U/L和CHC组的（85.65±27.77） U/L、（92.70±125.72）U/L,F值分别为3.911、4.081,P值均＜0.05,差异均有统计学意义.PBC组IgM水平为（4.60±2.67） g/L,显著高于

英文摘要：

Objective To explore the differential characteristics of the AMA-M2 autoantibody in patients with primary biliary cirrhosis （PBC） and non-PBC patients.Methods Patients with abnormal liver function at the Capital Medical University affiliated to Beijing You-an Hospital were enrolled in this study between January 2011 and December 2013.Serum levels ofANA,AMA and AMA-M2 were detected by indirect fluorescence assay and enzyme-linked immunosorbent assay.The patients＇ clinical data was obtained for retrospective analysis.Statistical analyses were performed using the SPSS 16.0 software.Enumeration data have been presented as numbers and percentages,and were analyzed using the chi-square test and one-way ANOVA test.Results Of the 5315 patients with abnormal liver function,15.3% （811/5315） were AMA-M2 positive patients;among those 811 patients,78.4% （636） had PBC,4.4% （36） had PBC overlapping with autoimmune hepatitis （AIH）,4.4% （36） had drug-induced liver injury,6.5% （53） had hepatitis B,3.3% （27） had hepatitis C,0.6% （5） had hepatitis E,0.9% （7） had alcoholic liver disease,0.5% （4） had non-alcoholic fatty liver,0.8% （6） had primary hepatic carcinoma,and 0.1% （1） had infectious mononucleosis.Serum AMA-M2 level was significantly higher in the PBC patients （vs.other groups,p 〈 0.001） with the exception of the patients with PBC/AIH overlap syndrome.Among the 811 patients with AMA-M2 positivity,88.5% （718） showed AMA positivity and 91.1% （739） showed ANA positivity.Serum alanine transferase （ALT） and aspartate transferase （AST） levels were significantly higher in the drag-induced liver injury patients （527.74±684.65 U/L,490.60±716.89 U/L） and the hepatitis E patients （1015.94±165.55 U/L,665.4±297.14 U/L） than in the PBC patients （96.02±115.56 U/L,94.82±83.32 U/L） （ALT：F =8.041,p 〈 0.001,p 〈 0.001;AST：F =8.066,p 〈 0.001,p 〈 0.001）.Serum alkaline phosphatase （ALP;265.16±179.08 U/L） and glutamyl transferase （GGT;