摘要

原发性硬化性胆管炎的病因尚不清楚，但与溃疡性结肠炎密切相关。血清抗结肠抗体与门静脉束的交叉反应在溃疡性结肠炎患者中有报道，但在原发性硬化性胆管炎中没有研究。测定了24例原发性硬化性胆管炎和溃疡性结肠炎患者血清抗结肠抗体和门脉抗体的频率;无溃疡性结肠炎的原发性硬化性胆管炎15例;无原发性硬化性胆管炎77例:克罗恩结肠炎25例;原发性胆汁性肝硬化10例;肝外胆道梗阻22例，正常对照组20例。应用免疫过氧化物酶技术检测正常结肠和阻塞肝脏的血清抗结肠抗体和门脉抗体。使用标准的微细胞毒技术进行组织分型。原发性硬化性胆管炎合并溃疡性结肠炎(62.5%)患者抗结肠抗体的频率明显高于溃疡性结肠炎(17%)和克罗恩性结肠炎(16%)患者(chi 2 = 17.9; p less than 0.001). The antibodies were almost entirely of IgG and IgA classes in all groups. Anticolon antibodies were not found in sera from any other group. Sera from eight of 15 patients with primary sclerosing cholangitis, ulcerative colitis and anticolon antibody reacted with portal tracts of human obstructed liver. This reaction was also seen in four of nine patients with ulcerative colitis and primary sclerosing cholangitis and in three of 15 patients with primary sclerosing cholangitis alone. Portal tract antibody was of IgG class and was not present in sera from any other groups. Unlike anticolon antibody, there was a close relationship between HLA-B8 phenotype and the portal tract antibody (p<0.02; chi 2 = 6.04). Absorption studies confirmed that the anticolon antibody is distinct from portal tract antibody.