不同基因型丙型肝炎病毒感染者的自身免疫表现  

Autoimmune manifestations of the patients infected by various HCV genotypes

作　　者：齐名[1] 熊华[1] 刘新钰[2] 吴引伟[2] 李鹤林[2] 李保仝[1] 宗永兰[1] 邵海枫[1] 

机构地区：[1]南京军区南京总医院全军医学检验中心,南京210002 [2]南京市第二医院

出　　处：《临床检验杂志》2002年第1期8-10,共3页Chinese Journal of Clinical Laboratory Science

基　　金：国家人事部留学回国人员科研基金资助 ( 9710 9)

摘　　要：目的　研究不同基因型HCV感染的丙型肝炎患者体内的自身抗体和其他免疫指标。方法　 2 4例丙肝患者为研究组 ,5 2例健康体检者为对照组。HCV感染用RT PCR证实。HCV基因型的检测用型特异性探针核酸杂交法检测。抗核抗体和抗平滑肌抗体用免疫荧光法检测 ,抗Sm抗体和抗RNP抗体用对流免疫电泳法检测 ,类风湿因子、抗双链DNA抗体、抗心磷脂抗体、抗甲状腺球蛋白抗体和抗甲状腺微粒体抗体用ELISA检测。冷球蛋白用冷沉淀法检测。免疫球蛋白水平用速率散射比浊法测定。循环免疫复合物用抗补体法测定。结果　 ( 1) 2 4例丙肝患者中 ,13例 ( 5 4 2 % )为Ⅱ型HCV(okamoto分型法 )感染 ,7例 ( 2 9 2 % )为Ⅲ型 ,2例 ( 8 3 % )为混和型 (Ⅱ型 +Ⅲ型 ) ,2例 ( 8 3 % )难以确定。 ( 2 )自身抗体检测 :患者组中有 10例( 4 1 7% )检出 2 1项次自身抗体。Ⅱ型HCV感染的 13例中有 7例检出 16项次 ,Ⅲ型HCV感染的 7例中有 1例检出 1项次 ,Ⅱ型和Ⅲ型混和感染的 2例中检出 4项次自身抗体。检出自身抗体的患者中有 7例检出类风湿因子 ,4例检出抗核抗体 ,4例检出抗心磷脂抗体 ,2例检出抗平滑肌抗体 ,2例检出抗甲状腺球蛋白抗体 ,1例检出抗甲状腺微粒体抗体 ,1例检出抗双链DNA抗体。结论　 ( 1)在本地区的丙肝患者中 。Objective:To investigate the spectrum of autoimmune antibodies as well as other immune parameters in the patients infected by various hepatitis C virus(HCV)genotypes.Methods The research group consisted of 24 cases of hepatitis C patients in contrast to the control group which consisted of 52 cases of healthy subjects.The infection of HCV was confirmed by RT PCR.The HCV genotypes were determined by molecular hybridization of nucleic acid with specific probes in terms of Okamoto Typing method.Various autoantibodies were detected by IIF,CIE or ELISA respectively.Cryoglobulin was detected by cold precipitation.Results 1. HCV genotypes:Of 24 cases of hepatitis C patiens,13(54.2%)were infected by HCV type Ⅱ,7(29.2%)were type Ⅲ,2(8.3%)were mixed (type Ⅱ and type Ⅲ)and 2(8.3%)were undefined.2. The autoantibodies:Twenty one autoantibodies were found in 10 (41.7%)patients.Among the patients,16 autoantibodies were found in 7 of 13 cases with HCV type Ⅱ,4 were in the 2 cases with mixed infection of type Ⅱ and Ⅲ while only one autoantibody were in 1 of 7 cases with HCV type Ⅲ.Conclusion:1. HCV type Ⅱ is predominant in the local patients with hepatitis C. 2. Autoantibodies can be found in a part of hepatitis C patients,and its prevalence is higher in the patients infected by HCV type Ⅱ of type Ⅱ and Ⅲ simultaneously than those infected by type Ⅲ alone. It is suggested that the process of autoimmune response in the patients infected by HCV type Ⅱ is more intensive.

关 键 词：丙型肝炎病毒 基因型 自身免疫 自身抗体 HCV 

分 类 号：R512.63[医药卫生—内科学]