原发性胆汁性肝硬化的实验诊断ppt课件.pptVIP

原发性胆汁性肝硬化的实验诊断;自身免疫性肝病;自身免疫性肝炎诊断标准;自身免疫性肝炎积分系统 (1999);自身免疫性肝炎分型;间接免疫荧光法ANASMAAMA间接免疫荧光法/免疫印迹法pANCA免疫印迹法/酶联免疫吸附法Anti-SLAAMA各种亚型间接免疫荧光法/免疫印迹法/酶联免疫吸附法Anti-LKM-1Anti-LC-l;抗核抗体应用指南;自身抗体--诊断指标？不出现自身抗体？（10%）自身抗体与AIH发病机制？抗线粒体抗体？;Incidence and prevalence of AIH;;原发性硬化性胆管炎(PSC);1、ALP、ALT、AST、γGT升高2、胆红素升高3、白蛋白下降，铜蓝蛋白增高4、高球蛋白血症（IgM、IgG)5、pANCA阳性6、T细胞下降，B细胞升高; Year Incidence Prevalence /100 000 /100 000 Norway 1998 1.31 8.5 Spain 1988 0.068 0.22 USA 1995 1-4 Sweden 1991 6;PSC in China mainland;PBC诊断标准;AMA的自身抗原;核膜抗体--核复合体gp210抗体--核心蛋白p62抗体 --核纤层蛋白B受体抗体 抗平滑肌抗体阳性抗核抗体：核膜及多核点型高度特异抗甲状腺抗体抗肾抗体抗DNA抗体类风湿因子;PBC的病变特征为门脉胆管非对称性破坏，组织学上分四期。一期：门脉局部炎症二期：胆管数减少，炎症向周围实质组织浸润三期：出现相邻门脉间的纤维间隔四期：终末期肝病，广泛硬化和再生结节;Leuschner M ，Dietrich C F，You T，et al. Characterisation of patients with primary biliary cirrhosis responding to Long term ursodeoxycholic acid treatment．Gut，2000，46：121—126;免疫球蛋白 高γ球蛋白血症，IgM呈多克隆性增高。 补体 C1增加， CH50和C1抑制因子也增加,C3, C4降低。细胞免疫功能降低 T、 NK减少，T细胞功能降低。PHA诱导的淋巴细胞转化率低于正常。 细胞因子 Th1/Th2细胞因子失衡。;PBC in China mainland;天然免疫方面 Increased expression of Toll like receptor 4 on peripheral-blood mononuclear cells in patients with coronary arteriosclerosis disease. Clin Exp Immunol 2006; 143(2):269-273. Granulysin, a cytolytic molecule, is also a chemoattractant and proinflammatory activator. J Immunol. 2005; 174(9):5243-8 Granulysin in immunity: more than just antimicrobial. Clin Invest Med J 2004. 自身抗原和抗体方面 Construction and expression of a humanized M(2) autoantigen trimer and its application in the diagnosis of primary biliary cirrhosis. World J Gastroenterol, 2003,9(6):1352-5 The expression and antigenicity identification of recombinant rat TGf-β1 in bacteria. Cell Research，2001 B细胞刺激因子方面 Real time quantitative measurement of the B Lymphocyte stimulator gene expression in peripheral blood mononuclear cells from patients with autoimmune diseases. Immunol 2004 Correlation of the expression levels of BLyS a