慢性乙型肝炎患者产生自身免疫的研究  

Autoimmunity of Patients after Chronic Hepatitis B Infection

作　　者：林晓梅[1] 潘钦石[1] 张文辉[1] 陈月平[2] 刘欢乐[1] 吴莲凤[1] 

机构地区：[1]温州医学院附属第一医院实验诊断中心,浙江温州325000 [2]温州医学院检验医学院,浙江温州325000

出　　处：《中华医院感染学杂志》2009年第8期889-891,共3页Chinese Journal of Nosocomiology

基　　金：温州市科技局资助课题(Y20070106)

摘　　要：目的探讨乙型肝炎病毒(HBV)感染后导致机体产生自身免疫的情况。方法采用日立7600全自动生化分析仪检测166例慢性乙型肝炎患者(CHB)的丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBil)、直接胆红素(DBil)、白球蛋白比值(A/G)、碱性磷酸酶(ALP)及γ谷氨酰酶(γ-GT);HBV-DNA含量的检测采用实时荧光定量PCR方法;采用间接免疫荧光法、放射免疫法分别检测抗核抗体(ANA)及抗双链DNA抗体(Ads-DNA)。结果166例CHB患者血清中总自身抗体检出率为36.7%,显著高于正常对照组(P<0.01),且分布以低滴度为主;ANA阳性组的ALT、AST显著高于ANA阴性组(P<0.05),而A/G比值明显低于ANA阴性组(P<0.05);ANA阳性组的HBV-DNA含量显著高于ANA阴性组(P<0.01),且随着HBV-DNA拷贝数的升高,CHB患者ANA的阳性率亦随之升高,差异有统计学意义(P<0.01)。结论HBV感染可导致自身免疫的发生;HBV感染引发的自身免疫性反应与CHB患者的肝功能损害程度和病毒复制水平有关。OBJECTIVE To investigate the condition of autoimmunity in patients after hepatitis B virus （HBV） infection. METHODS The level of ALT, AST, A/G, ALP and γ-GT was detected by Hitachi Model 7600 Series Automatic Analyzer in 166 patients with chronic hepatitis B（CHB）. The concentration of HBV-DNA was detected by fluorescence real-time quantitative polymerase chain reaction（FQ-PCR）. Antinuclear antibody（ANA） and antidouble strain DNA antibodies （Ads-DNA） were measured by using indirect immunofluorescent assay and radioimmunoassay respectively. RESULTS Compared to those in healthy control groups, the positive rate of autoantibodies was significantly higher in 166 patients with CHB（P〈0.01）. Compared to the patients with HBV infection without autoantibodies, the level of ALT, AST and HBV-DNA significantly increased in patients with autoantibodies, but the level of A/G was opposite. On the increase in the level of HBV-DNA, the positive rates of ANA increased （P〈0. 01）. CONCLUSIONS HBV infection can induce autoimmune reaction. The autoimmune reaction is related to the liver dysfunction severity and the level of HBV-DNA.

关 键 词：慢性乙型肝炎 自身抗体 抗核抗体 乙型肝炎病毒DNA 

分 类 号：R512.62[医药卫生—内科学]