乙型肝炎患者自身抗体的特点分析  

Features of autoantibodies in patients with hepatitis B

作　　者：王蓉[1,2] 耿秀蓉[3] 洪华[1,2] 谭太昌[1,2] 王智斌[1,2] 

机构地区：[1]四川省医学科学院 [2]四川省人民医院检验科,四川成都610072 [3]四川省第二中医医院检验科,四川成都610031

出　　处：《实用医院临床杂志》2010年第6期85-87,共3页Practical Journal of Clinical Medicine

摘　　要：目的分析乙型肝炎患者体内自身抗体的特点,探讨自身抗体在乙型肝炎的病因和发病机制中的作用。方法采用间接免疫荧光法和欧蒙印迹法检测150例乙型肝炎患者(HBV组)、31例自身免疫性肝炎患者(AIH组)和100例健康人血清中的抗核抗体(ANA)、抗平滑肌抗体(SMA)、抗线粒体抗体(AMA)、抗肝肾微粒体抗体(LKM-1)、抗肝特异性蛋白抗体(LSP)、抗胃壁细胞抗体(APCA)、抗心肌抗体(AHRA)、抗可溶性肝抗原/抗肝胰抗原(SLA/LP)、抗线粒体II型抗体(AMA-M2)、肝溶质抗原I型(LC-1)等自身抗体,并进行分析。结果 HBV组ANA、LKM-1、SAMA、AMA-M2、APCA阳性率分别是12.67%、0.67%、0.67%、0.67%、0.67%,而且阳性滴度都低于1∶320,阳性结果中89.47%滴度都处于1∶100,均低于AIH组,以高滴度为主,差异有统计学意义(P<0.05);乙型肝炎DNA阳性组自身抗体阳性率高于DNA阴性组(P<0.05),ANA阳性组和阴性组肝功能有差异,ANA阳性组的AST、ALT明显高于ANA阴性组(P<0.05)。结论乙型肝炎患者血清中存在多种自身抗体,但与自身免疫性肝炎相比滴度较低;HBV引起的自身免疫紊乱尤其是病毒处于复制状态是造成机体免疫损的机制之一,可能引起肝功能损伤。Objective To analyze the features of autoantibodies in patients with hepatitis B and approach autoantibodies in role of etiology and pathogenesis of hepatitis B.Methods Autoantibodies such as ANA,ASMA,AMA,LKM-1,LSP,APCA,AHRA,SLA/LP,AMA-M2 and LC-1 were detected and analyized from serum samples of 150 patients with hepatitis b virus （HBV group）,31 patients with autoimmune hepatitis （AIH group） and 100 healthy people.Results Positive rates of ANA,LKM-1,ASMA,AMA-M2 and APCA in HBV group with lower titer （1：100）,which were significantly lower than those in AIH group with higher titer,were 12.67%,0.67%,0.67%,0.67% and 0.67% respectively （P0.05）.For HBV patients,the positive rate of autoantibodies in patients with positive DNA was significantly lower than that in patients with negative DNA （P 0.05）,while levels of AST and ALT in patients with positive ANA were significantly higher than those in patients with negative ANA （P 0.05）.Conclusion There are various autoantibodies in serum of patients with HBV.The titer of HBV is lower than that of AIH.HBV,especially in replication status,induced autoimmune disorders is one of the mechanisms cause to immune damage,which may lead to liver injury.

关 键 词：乙型肝炎 自身免疫性肝炎 自身抗体 免疫印迹法 间接免疫荧光法 

分 类 号：R512.62[医药卫生—内科学]