ITP病例回顾分析:人静脉丙种球蛋白治疗可致乙型肝炎检测的误判?  

Retrospective analysis of ITP:misleading hepatitis test results due to intravenous immunoglobulin administration?

作　　者：王宏梅[1] 杨艳辉[1] 许剑辉[1] 刘晓帆[1] 薛峰[1] 杨仁池[1] 

机构地区：[1]中国医学科学院 北京协和医学院血液病区院(血液学研究所),天津300020

出　　处：《临床血液学杂志》2012年第3期288-291,共4页Journal of Clinical Hematology

基　　金：国家自然科学基金(No:81070397);天津自然科学基金(No:09JCYBJC10900;10JCZDJC19700)

摘　　要：目的:研究人静脉丙种球蛋白(IVIG)治疗对患者乙型肝炎检测的影响。方法:回顾分析原发性免疫性血小板减少症患者病例,分析乙型肝炎检测中抗HBe抗体(anti-HBeAb)阳性和(或)抗HBc抗体(anti-HB-cAb)阳性的非乙型肝炎患者的治疗情况。结果:Anti-HBeAb和(或)anti-HBcAb阳性的53例患者中有50例(94.3%)使用了IVIG,其余3例(6.7%)从未用过IVIG。2例患者用IVIG前乙型肝炎标志物检测为阴性,IVIG使用后,检测显示anti-HBeAb和(或)anti-HBcAb阳性。IVIG暴露患者在治疗后anti-HBeAb和(或)anti-HB-cAb阳性组显著多于anti-HBeAb和anti-HBcAb阴性组,经χ2检验,P<0.01;经Fisher精确检验,P<0.05。Anti-HBeAb阳性组,IVIG暴露患者显著多于无IVIG暴露患者(P<0.01)。Anti-HBcAb阳性组,IVIG暴露患者显著多于无IVIG暴露患者(P<0.01)。结论:IVIG治疗可能影响乙型肝炎标志物检测结果,可能造成乙型肝炎标志物检测结果的误判。Objective：To study the impact of intravenous gammaglobulin treatment on hepatitis B testing in primary immune thrombocytopenia（ITP） patients. Method：The case records of ITP patients were retrospectively analyzed and the treatment options in non-hepatitis B patients with positive anti-HBeAb and（or） anti-HBcAb were analyzed. Result：Among the 53 ITP patients with positive anti-HBeAb and（or） anti-HBcAb,50（94.3%） patients received IVIG and the remaining 3 cases（6.7%） did not received IVIG.Two patients who had negative result pre IVIG administration got positive anti-HBeAb and/（or） anti-HBcAb after IVIG administration.The ratio of patients with IVIG exposure in positive anti-HBeAb and/（or） positive anti-HBcAb was significantly higher than in both negative of anti-HBeAb and anti-HBcAb group（P0.01,Chi-square Test;P0.05,Fisher Exactly Test）.In patients with positive anti-HBeAb,IVIG exposure cases were significantly more than non-IVIG exposure cases（P0.01）.In patients with positive anti-HBcAb,IVIG exposure cases were significantly more than non-IVIG exposure cases（P0.01）. Conclusion：IVIG treatment maybe affect hepatitis B test results and maybe lead to misleading hepatitis test results.

关 键 词：血小板减少性紫癜 丙种球蛋白 乙型肝炎 

分 类 号：R554[医药卫生—血液循环系统疾病]