Schuurman H J, Vogten A J, Schalm S W, Fevery J
Digestion. 1982;23(3):184-93. doi: 10.1159/000198726.
To evaluate the clinical significance of the liver cell membrane autoantibody (LMA) assay, we studied the presence, titre and immunoglobulin classes of LMA in 162 patients with various liver diseases and 156 controls. LMA was detected predominantly in patients with HBsAg-negative chronic active hepatitis (73% of 26 patients), but was also found in lower prevalences in other liver diseases, such as primary biliary cirrhosis syndrome (43% of 28 patients). LMA-positive primary biliary cirrhosis patients could be distinguished from LMA-positive patients with other liver diseases by the virtual absence of IgG class LMA. The LMA assay adds to the panel of assays for non-organ-specific autoantibodies in that it is more specific for autoimmune liver disease and in that it increases the diagnostic yield of autoantibody assays, e.g. in HBsAg-negative chronic active hepatitis from 77 to 92%. Immunosuppressive therapy status and biochemical parameters of disease activity, such as transaminase values, did not show a statistically significant relationship with the prevalence, the titre and the immunoglobulin class of LMA. It is concluded, that LMA is a sensitive and specific diagnostic marker for autoimmune liver disease.
为评估肝细胞膜自身抗体（LMA）检测的临床意义，我们研究了162例各种肝病患者和156例对照者体内LMA的存在情况、滴度及免疫球蛋白类别。LMA主要在乙肝表面抗原（HBsAg）阴性的慢性活动性肝炎患者中检测到（26例患者中的73%），但在其他肝病中也有较低的阳性率，如原发性胆汁性肝硬化综合征（28例患者中的43%）。LMA阳性的原发性胆汁性肝硬化患者与其他肝病的LMA阳性患者可通过几乎不存在IgG类LMA来区分。LMA检测增加了非器官特异性自身抗体的检测项目，因为它对自身免疫性肝病更具特异性，并且提高了自身抗体检测的诊断率，例如在HBsAg阴性的慢性活动性肝炎中，诊断率从77%提高到92%。免疫抑制治疗状态和疾病活动的生化参数，如转氨酶值，与LMA的患病率、滴度及免疫球蛋白类别均无统计学上的显著关系。结论是，LMA是自身免疫性肝病的敏感且特异的诊断标志物。
