肝脏 ›› 2025, Vol. 30 ›› Issue (8): 1111-1114.

• 其他肝病 • 上一篇    下一篇

AMA、抗LC-1抗体联合IL-17检测对自身免疫性肝炎的诊断价值

詹有芳, 蒋秀娣, 徐正, 王鹏   

  1. 200021 上海 上海中医药大学附属曙光医院检验科(詹有芳);200137 上海 上海市第七人民医院(蒋秀娣,徐正,王鹏)
  • 收稿日期:2024-08-20 发布日期:2025-09-19
  • 通讯作者: 王鹏,Email:wanghahapeng@sina.cn
  • 基金资助:
    上海市浦东新区卫生健康委员会重要薄弱学科:检验与病理学课题资助(PWZbr2022-08)

Study on the application value of AMA, anti-LC-1 antibody and IL-17 in the diagnosis of autoimmune hepatitis

ZHAN You-fang1, JIANG Xiu-di2, XU Zheng2, WANG Peng2   

  1. 1. Department of Clinal Lab,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese ,Shanghai 200021,China;
    2. Department of Clinal Lab, the Seven People’s Hospital of Shanghai,Shanghai 200137, China
  • Received:2024-08-20 Published:2025-09-19
  • Contact: WANG Peng, Email:wanghahapeng@sina.cn

摘要: 目的 评估抗线粒体抗体(AMA)、抗肝细胞溶质抗原-1抗体(抗LC-1抗体)与白细胞介素-17(IL-17)联合检测对自身免疫性肝炎(AIH)的诊断价值。 方法 纳入2023年1月至2024年1月间上海中医药大学附属曙光医院健康体检者50名为健康组,AIH患者50例为AIH组,病毒性肝炎患者50例为肝炎组。比较3组的肝功能、IL-17、AMA、抗LC-1抗体的阳性检出率,以及AMA各核型的检出率。以受试者工作特征曲线下面积(AUC)评估AMA、抗LC-抗体1、IL-17单独检测和三者联合检测的诊断效能。 结果 AIH组的IL-17、DBil、TBil、ALT、ALP、AST、GGT水平均高于健康组,而白球比低于健康组,差异有统计学意义(P<0.05)。AIH组与肝炎组的TBil、DBil、AST、ALT、ALP、GGT水平、白球比差异无统计学意义(P>0.05)。AIH组的IL-17水平为(29.1±3.5)pg/mL,肝炎组为(18.3±3.1)pg/mL,健康组为(13.5±2.1)pg/mL,差异有统计学意义(t=12.25、11.64,P<0.05)。AIH组的AMA、抗LC-1抗体及相关抗体联合检测阳性检出率高于健康组与肝炎组,且差异有统计学意义(P<0.05)。AMA诊断AIH的AUC为0.774,95%CI为0.690~0.857;抗LC-1抗体诊断的AUC为0.57,95%CI为0.505~0.635;IL-17诊断的AUC为0.83,95%CI为0.737~0.924;3项指标联合检测时,AUC为0.958,95%CI为0.917~0.998。 结论 AMA、抗LC-1抗体联合IL-17检测对AIH的临床诊断价值较高。

关键词: 自身免疫性肝炎, AMA, 抗LC-1抗体, IL-17, 自身抗体

Abstract: Objective To evaluate the clinical diagnostic value of combined detection of anti-mitochondrial antibody(AMA),Anti-lc-1 antibody and interleukin-17(IL-17) in autoimmune hepatitis. Methods The study included 50 healthy individuals who underwent physical examination at our hospital from January 2023 to January 2024 as the healthy group, and 50 patients with autoimmune hepatitis diagnosed at our hospital during the same period as the AIH group, 50 patients with viral hepatitis diagnosed at our hospital during the same period as the viral group.IL-17 index, the positive detection rate of AMA and anti-LC-1 antibody, the distribution and positive rate of AMA titer, and the detection rate of AMA karyotypes were compared among the three groups, and the levels of AMA, anti-LC-1 antibody and IL-17 were observed between the viral group and the immune group. The ROC curves of AMA, anti-LC-antibody-1 and IL-17 were evaluated separately and in combination. Results The levels of IL-17, direct bilirubin (DBIL), and total bilirubin (TBIL), aspartate aminotransferase (AST),alanine aminotransferase (ALT), alkaline phosphatase (ALP), γ-glutamyltransferase (GGT) in the AIH group were higher than those in the healthy group, while the white-to-red blood cell ratio was lower than that in the healthy group, with statistically significant differences (P<0.05). There was no significant difference in the levels of DBIL,TBIL,AST,ALT, ALP, GGT, and the ratio of white blood cells to red blood cells between the AIH group and the virus group (P>0.05). The IL-17 level in the immunized group was 29.1±3.5 pg/mL, the IL-17 level in the virus group was 18.3±3.1 pg/mL, and the IL-17 level in the healthy group was 13.5±2.1 pg/mL. The immunized group was significantly higher than the healthy group and the virus group, with statistically significant differences t=12.25, 11.64, P<0.05.The positive rate of AMA, anti-LC-1 antibody and related antibody combined detection in immune group was higher than that in healthy group and viral group, and the difference was statistically significant (P<0.05). The AUC of AMA for diagnosing autoimmune hepatitis was 0.774, with a 95% CI of 0.690~0.857; The AUC of anti-LC-1 antibody diagnosis was 0.57, with a 95% CI of 0.505~0.635; The AUC of IL-17 diagnosis was 0.83, with a 95% CI of 0.737~0.924; When the three indicators were jointly detected, the AUC was 0.958, and the 95% CI was 0.917~0.998. Conclusion This study demonstrates that combined detection of AMA, anti-LC-1 antibody, and IL-17 has high accuracy in the clinical diagnosis of autoimmune hepatitis, providing reliable data support for clinical practice and facilitating early detection and effective treatment of the disease.

Key words: Autoimmune hepatitis, AMA, Anti-LC-1 antibody, IL-17, Autoantibodies