乙型肝炎自然病程中免疫逃逸期肝纤维化Ⅰ～Ⅳ期HBsAg水平的动力学研究  

Dynamic changes of HBsAg expression by the same hepatic parenchyma cells volume at different liver fibrosis stages in immune escape phase

作　　者：刘婷[1] 谢仕斌[2] 吴泽倩[2] 张立伐[1] 闵筱辉[1] 柯伟民[2] 高志良[2] 

机构地区：[1]中山大学孙逸仙纪念医院感染病科,广东广州510120 [2]中山大学附属第三医院传染病学教研室

出　　处：《胃肠病学和肝病学杂志》2011年第8期708-711,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的研究乙型肝炎自然病程中免疫逃逸期肝纤维化Ⅰ、Ⅱ、Ⅲ和Ⅳ期血清HBsAg水平以及用相同肝实质细胞体积分摊的肝纤维化Ⅰ、Ⅱ、Ⅲ和Ⅳ期血清HBsAg水平的动力学特点。方法应用电化学发光法检测和两两比较肝纤维化Ⅰ、Ⅱ、Ⅲ和Ⅳ期血清HBsAg的水平;并且,进一步用相同肝实质细胞体积分摊并且两两比较肝纤维化Ⅰ、Ⅱ、Ⅲ和Ⅳ期血清HBsAg的水平。结果 肝纤维化Ⅰ、Ⅱ、Ⅲ和Ⅳ期的血清HBsAg水平分别为(6 482.86±2 725.05)COI/mL、(7 558.18±2 011.60)COI/mL、(6 212.00±2 483.61)COI/mL和(6 053.81±2 958.06)COI/mL,用相同肝实质细胞体积进行分摊,在肝纤维化Ⅰ、Ⅱ、Ⅲ和Ⅳ期的HBsAg水平分别为(9 812.11±4 124.49)COI/mL、(12 050.66±3 207.26)COI/mL、(10 528.81±4 209.51)COI/mL和(11 409.36±5 574.93)COI/mL,无论分摊前和分摊后4期之间无明显差异(F分摊前=1.244,P=0.307和F分摊后=0.862,P=0.465)。结论慢性乙型肝炎免疫逃逸期肝纤维化从Ⅰ期向Ⅳ期进展,即使在相同肝实质细胞体积分摊的前提下,HBsAg表达仍然保持稳定的水平。Objective To clarify the dynamic changes of HBsAg expression by the same hepatic parenchyma cells volume among liver fibrosis stagesⅠ,Ⅱ,Ⅲ and Ⅳ in immune escape phase. Methods The serum HBsAg levels and the apportioned levels according to the same hepatic parenchyma cells volume at liver fibrosis stagesⅠ,Ⅱ,Ⅲ and Ⅳ were detected and compared by twos among the different stages. Results The serum HBsAg levels were（6 482.86±2 725.05） COI/mL,（7 558.18±2 011.60） COI/mL,（6 212.00±2 483.61） COI/mL and（6 053.81±2 958.06）COI/mL at liver fibrosis stagesⅠ,Ⅱ,Ⅲ and Ⅳ.There were no differences among liver fibrosis stagesⅠto Ⅳ（F=1.244,P=0.307）.Furthermore,the serum HBsAg levels apportioned by the same hepatic parenchyma cells volume at liver fibrosis stagesⅠ,Ⅱ,Ⅲ and Ⅳ were（9 812.11±4 124.49） COI/mL,（12 050.66±3 207.26） COI/mL,（10 528.81±4 209.51） COI/mL and（11 409.36±5 574.93）COI/mL,respectively.There were also no significant differences among liver fibrosis stages Ⅰ to Ⅳ（F=0.862,P=0.465）. Conclusion During the immune escape phase of chronic hepatitis B,HBsAg expression remains stable even though it is apportioned by the same hepatic parenchyma cells volume along with liver fibrosis stage progressed from stageⅠto Ⅳ.

关 键 词：慢性乙型肝炎 肝纤维化分级 HBSAG水平 肝实质细胞体积 

分 类 号：R575[医药卫生—消化系统]