van de Wiel A, van Hattum J, Schuurman H J, Kater L
Department of Internal Medicine, University Hospital, Utrecht, The Netherlands.
Gastroenterology. 1988 Feb;94(2):457-62. doi: 10.1016/0016-5085(88)90437-4.
The diagnostic relevance of the serum immunoglobulin A (IgA) concentration and liver deposition of IgA for chronic excessive alcohol consumption was evaluated in 164 patients with biochemical liver abnormalities. A relationship was demonstrated between the amount of daily alcohol consumption and the two IgA parameters and serum gamma-glutamyl transpeptidase. A continuous pattern of IgA deposition along hepatic sinusoids proved to be the best diagnostic feature, combining a specificity of 0.91 with a sensitivity of 0.75. Although serum IgA has a specificity of 0.78, its diagnostic value is restricted by a sensitivity of 0.50, making it not superior to serum gamma-glutamyl transpeptidase. Furthermore, serum IgA proved to be related to liver histopathology. High levels of serum IgA are found in hepatitis and cirrhosis, without significant differences between alcoholic and nonalcoholic patients. However, in the case of mild histopathologic changes in the liver, such as steatosis and fibrosis, significantly higher serum IgA concentrations are found in alcoholic than in nonalcoholic liver disease.
在164例有生化肝脏异常的患者中，评估了血清免疫球蛋白A（IgA）浓度和IgA在肝脏中的沉积对于慢性过量饮酒的诊断相关性。研究表明每日饮酒量与两个IgA参数以及血清γ-谷氨酰转肽酶之间存在关联。沿肝血窦的IgA沉积呈连续模式被证明是最佳诊断特征，其特异性为0.91，敏感性为0.75。虽然血清IgA的特异性为0.78，但其诊断价值因敏感性为0.50而受限，这使其并不优于血清γ-谷氨酰转肽酶。此外，血清IgA被证明与肝脏组织病理学相关。在肝炎和肝硬化患者中发现血清IgA水平较高，酒精性和非酒精性患者之间无显著差异。然而，在肝脏存在轻度组织病理学改变（如脂肪变性和纤维化）的情况下，酒精性肝病患者的血清IgA浓度显著高于非酒精性肝病患者。
