南方地区成人年度健康体检人群原发性胆汁性胆管炎的患病率。
Prevalence of primary biliary cirrhosis in adults referring hospital for annual health check-up in Southern China.
机构信息
Clinical Laboratory, Guangzhou Women and Children’s Medical Center, 9 Jinsui Road, Guangzhou 510623, China.
出版信息
BMC Gastroenterol. 2010 Sep 3;10:100. doi: 10.1186/1471-230X-10-100.
BACKGROUND
Primary biliary cirrhosis (PBC) is an autoimmune liver disease characterized by the presence of anti-mitocondrial autoantibodies (AMA) which has an essential role also for diagnosis. In addition, also some anti-nuclear antibodies (ANA) have been shown to be highly specific PBC. The purpose of this study was to assess the prevalence of PBC among the adults referring hospital for annual health check-up in Southern China by screening sera for PBC-specific autoantibodies.
METHODS
AMA and ANA were screened in 8,126 adults (mean age 44 ± 15 years, 48% females) by indirect immunofluorenscence (IIF). Positive sera were tested by ELISA/immunoblotting for AMA-M2, anti-sp100 and anti-gp210. A diagnosis of PBC was re-assessed six months after the initial testing.
RESULTS
Out of 8,126 individuals 35 were positive for AMA and 79 positive for ANA. Nineteen, 4, and 3 of the subjects positive for AMA and/or ANA showed reactivity for AMA-M2, anti-sp100 or gp210, respectively, further tested with ELISA/immunoblotting. Fourteen in the 39 individuals positive for AMA at IIF, AMA-M2, anti-gp210, or anti-sp100 had abnormal cholestatic liver functional indices. One definite and 3 probable PBC diagnosis could be made in 4 cases including 3 females and 1 male after half a year.
CONCLUSIONS
We found a point prevalence rate of PBC among Southern Chinese adults attending for yearly health check-up of 492 cases per million (95% CI, 128 to 1,093) and 1,558 cases per million (95% CI, 294 to 3,815) for women over 40, a finding similar to prevalence reported in other geographical areas.
背景
原发性胆汁性肝硬化（PBC）是一种自身免疫性肝病，其特征是存在抗线粒体自身抗体（AMA），该抗体对诊断也具有重要作用。此外，一些抗核抗体（ANA）也被证明对 PBC 具有高度特异性。本研究旨在通过筛查 PBC 特异性自身抗体来评估中国南方地区年度健康体检人群中 PBC 的患病率。
方法
通过间接免疫荧光法（IIF）对 8126 名成年人（平均年龄 44 ± 15 岁，48%为女性）进行 AMA 和 ANA 筛查。对阳性血清通过 ELISA/免疫印迹法检测 AMA-M2、抗 sp100 和抗 gp210。在初次检测后 6 个月重新评估 PBC 的诊断。
结果
在 8126 名个体中，有 35 名 AMA 阳性，79 名 ANA 阳性。19、4 和 3 名 AMA 和/或 ANA 阳性的受试者分别对 AMA-M2、抗 sp100 或 gp210 有反应，进一步用 ELISA/免疫印迹法检测。在 39 名 IIF 阳性的 AMA 个体中，14 名 AMA-M2、抗 gp210 或抗 sp100 有异常的胆汁淤积性肝功能指标。在包括 3 名女性和 1 名男性在内的 4 例患者中，经过半年时间，可以做出明确和可能的 PBC 诊断各 1 例。
结论
我们发现，在中国南方地区，参加年度健康体检的成年人中，PBC 的现患率为每百万人 492 例（95%可信区间，128 至 1093 例），40 岁以上女性为每百万人 1558 例（95%可信区间，294 至 3815 例），这一发现与其他地理区域报道的患病率相似。
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