摘要目的 研究抗核抗体(ANA)在慢性乙型肝炎中的表达情况,并探讨其与慢性乙型肝炎误诊的关系及降低误诊发生的措施.方法 检测614例乙型肝炎患者血清中ANA滴度,生化指标丙氨酸转移酶(ALT)和天冬氨酸转移酶(AST),及乙肝病毒标志物,即乙肝表面抗原(HBsAg),乙肝表面抗体(HBsAb),乙肝e抗体(HbeAb),乙肝核心抗体(HBcAb),乙肝e抗原(HBeAg).比较乙肝活动组与非活动组的ANA阳性率,ANA阳性组与ANA阴性组间各乙肝检测项目的 阳性率,对ANA与各乙肝项目间进行关联分析,比较肝功能正常组与肝功能异常组间ANA的检测结果.结果 乙肝活动组ANA阳性率高于非活动组(P＜0.001);肝功能正常组与异常组间ANA检测结果差异无统计学意义(P＞0.05);ANA阳性组的HBeAg,ALT和AST阳性率均高于阴性组(P＜0.001),ANA阴性组的HbsAb和HBeAb阳性率均高于阳性组(P＜0.001);ANA与HBeAg间存在正相关(P＜0.05).结论 慢性乙型肝炎出现ANA阳性可能由肝细胞损伤致细胞内成分释放入血引起,临床工作中结合生化检查,病史,临床表现及其他辅助手段可提高诊断准确率,减少误诊的发生.

abstractsObjective The expression of ANA in the chronic HBV,then explore its relationship with misdiagnosis of chronic HBV and the methods to reduce misdiagnosis.Methods To detect the titer of ANA and the concentration of ALT and AST were detected in 614 HBV patients's serum.In these patients,the HBV markers were also detected,including HBsAg,HBsAb,HBeAb,HBcAb and HBeAg.The positive rate of ANA was compared in HBV activity group with non-active group,and compared the positive rate of such HBV inspective items in ANA positive group with the ANA negative group,conducted the correlation analysis of ANA and HBV inspective items,then compare the ANA test results of the normal liver function group with the abnormal liver function group.Results The positive rate of ANA was higher in the HBV activity group compare to the non-active group( P ＜ 0.001) ;there was no difference of the positive rate of ANA in normal liver function group and abnormal liver function group( P ＞0.05) ;the positive rates of HBsAb and HBeAb were higher in the ANA positive group compare to the ANA negative group( P ＜ 0.001) ;there is positive correlation between ANA and HBeAg(P ＜ 0.05).Conclusion The damage of liver cells cause the cell components release into blood,it may lead to the positive of ANA in chronic HBV.In clinical,to combine biochemical tests,history,clinical manifestation and others supplementary means can increase the diagnostic accuracy and reduce misdiagnosis.