Rüegg R, Matter L, Schopfer K, Grob P J
Schweiz Med Wochenschr. 1985 Mar 2;115(9):290-6.
Clinical, histological and serological data of 72 patients with antimitochondrial antibodies (AMA) were analyzed. 56 (78%) of the patients exhibited chronic cholestatic hepatopathy; in 30 of these primary biliary cirrhosis (PBC) was diagnosed and in 26 "possible PBC". The remaining 16 patients were subsumed in an "other illness' group. A collagen or autoimmune disease was found in 8 patients of the chronic cholestatic hepatopathy group and in 3 of the "other illness" group. Histological findings were diagnostic for PBC or cirrhotic liver in 90% of the patients with clinical signs, while 64% of the symptomfree patients had unspecific histological liver alterations. In general, increasing serum IgM, alkaline phosphatase, gamma-GT and symptoms paralleled increasing AMA titers, although asymptomatic patients with high AMA titers were also seen. The prevalence of hepatopathies rose with increasing AMA titers, but otherwise no association of AMA titers and diagnosis was observed. Therefore, a positive AMA test bears out suspicion of hepatopathy, but cannot be regarded as specific for PBC when other liver signs are absent.
分析了72例抗线粒体抗体（AMA）阳性患者的临床、组织学和血清学数据。其中56例（78%）患者表现为慢性胆汁淤积性肝病；其中30例被诊断为原发性胆汁性肝硬化（PBC），26例为“可能的PBC”。其余16例患者归入“其他疾病”组。在慢性胆汁淤积性肝病组的8例患者和“其他疾病”组的3例患者中发现了胶原或自身免疫性疾病。组织学检查结果显示，90%有临床症状的患者可诊断为PBC或肝硬化，而64%无症状患者有非特异性肝脏组织学改变。总体而言，血清IgM、碱性磷酸酶、γ-GT升高及症状与AMA滴度升高平行，不过也有AMA滴度高但无症状的患者。肝病患病率随AMA滴度升高而上升，但未观察到AMA滴度与诊断之间的其他关联。因此，AMA检测呈阳性可证实对肝病的怀疑，但在无其他肝脏体征时，不能视为PBC的特异性指标。
