慢性丙型肝炎患者血清HCV RNA载量与丙型肝炎抗体及抗核抗体的相关性  

Correlations between HCV RNA load and titers of antiHCV antibody and anti-nuclear antibody in chronic hepatitis C patients

作　　者：贾艳会[1] 范志娟[1] 郭华[2] 周淑芬[1] 刘树业[1] 

机构地区：[1]天津市第三中心医院检验科,天津市300170 [2]天津市第三中心医院肝胆病研究所,天津市300170

出　　处：《世界华人消化杂志》2015年第23期3766-3770,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨丙型肝炎病毒(hepatitis C virus,HCV)RNA载量与抗-HCV滴度的相关性,分析HCV RNA载量与抗核抗体(antinuclear antibody,ANA)滴度的变化规律及干扰素治疗前后ANA滴度的变化,为慢性丙型肝炎(chronic hepatitis C,CHC)的治疗提供指导.方法:收集2013-01/2014-02收治天津市第三中心医院的112例CHC患者血清,实时荧光定量聚合酶链反应检测HCV RNA,ELISA法检测抗-HCV,间接免疫荧光法检测ANA,Log HCV RNA与抗-HCV滴度及ANA滴度的相关性采用Spearman相关分析,采用独立样本的t检验及多个独立样本非参数检验分析Log HCV RNA与ANA滴度的关系.干扰素治疗前及治疗1 mo后ANA滴度的比较采用秩和检验.结果:HCV RNA载量与抗-HCV滴度不存在相关关系(r=0.078,P=0.465);HCV R N A载量与A N A滴度存在相关关系(r=0.744,P=0.001),ANA阳性与ANA阴性患者的HCV RNA载量有差异(P=0.001);不同ANA滴度组HCV RNA载量有差异(χ2=32.58,P=0.001).干扰素治疗前后ANA滴度变化有统计学意义(Z=2.60,P=0.001).C H C患者的A N A以低滴度为主,随着病毒载量的增高,高滴度的ANA例数有增多的趋势.结论:HCV RNA载量的高低可作为抗病毒疗效评估的观察指标;CHC患者存在一定程度自身免疫现象;干扰素治疗过程中会增强自身免疫的发生.AIM： To investigate the correlations between hepatitis C virus（HCV） RNA load and the titers of anti-HCV antibody and anti-nuclear antibody（ANA）, and the change in ANA titers before and after interferon treatment, to provide guidance for the treatment of chronic hepatitis C（CHC）.METHODS： Serum samples were collected from 112 patients with CHC from January 2013 to February 2014 at Tianjin Third Central Hospital. Real-time fluorescence quantitative polymerase chain reaction（FQ-PCR） was performed to detect HCV RNA, ELISA was used for the detection of anti-HCV antibody, and indirect immunofluorescence（IIF） was performed for the detection of ANA. Spearman correlation analysis was used to analyse the correlations between Log HCV RNA and the titers of anti-HCV antibody and ANA. Independent samples t-test and K independent samples test analysis were used to analyse the correlation between Log HCV RNA and the titer of ANA. Rank sum test was used to compare ANA titers before and after treatment with interferon for one month.RESULTS： There was no correlation between HCV RNA load and the titer of anti-HCV antibody（r = 0.078, P = 0.465）. There was a correlation between HCV RNA load and ANA titer（r = 0.744, P = 0.001）. There was a significant difference in HCV RNA between the ANA（＋）/（-） groups（P = 0.001）. HCV RNA varied among different titers of ANA（χ2 = 32.58, P = 0.001）. The change in ANA titers before and after interferon treatment was statistically significant（Z = 2.60, P = 0.001）. Most CHC patients had a low titer of ANA. With the increase in viral load, the number of patients with a high titer of ANA had an increasing trend.CONCLUSION： HCV RNA can be used to evaluate the antiviral effect. There is a certain degree of autoimmune phenomenon in patients with CHC.Interferon can enhance autoimmunity in the course of therapy.

关 键 词：慢性丙型肝炎 丙型肝炎病毒RNA 丙型肝炎抗体 抗核抗体 干扰素 

分 类 号：R512.63[医药卫生—内科学]