系统性红斑狼疮和类风湿关节炎患者的乙型肝炎病毒感染临床分析  

Clinical analysis of hepatitis B virus infection in patients with systemic lupus erythematosus and rheumatoid arthritis

作　　者：王芬[1] 吕树娟[2] 蔡静玉 周香莲[1] 徐建华[1] 

机构地区：[1]安徽医科大学第一附属医院风湿免疫科,安徽合肥230022 [2]安徽医科大学微生物教研室,安徽合肥230022

出　　处：《安徽医药》2016年第7期1287-1291,共5页Anhui Medical and Pharmaceutical Journal

基　　金：国家自然科学基金资助项目(81401291)

摘　　要：目的探讨系统性红斑狼疮(SLE)、类风湿关节炎(RA)患者乙型肝炎病毒(HBV)的感染情况。方法收集确诊系统性狼疮性346例、类风湿关节炎294例为病例组,收集其HBV血清学标记物结果,记录其临床资料、相关实验室检查数据。结果:健康人对照组(同年体检的健康人群12 779人)HBs Ag、HBs Ab、HBe Ag、HBe Ab、HBc Ab的阳性率分别6.6%、59.0%、0.5%、8.0%、21.2%。SLE组阳性率分别0.6%,、41.3%、0.0%、1.4%、2.9%;RA组的阳性率分别7.1%、57.8%、1.0%、6.8%、16.3%,结果 RA患者HBV感染和普通人群相似,SLE患者的HBV各项指标阳性率均低于RA患者(P=0.001)、也明显低于普通人群。HBV感染与SLE/RA相关临床指标、自身抗体的关系分析,结果显示差异无统计学意义(P>0.05)。结论 RA患者和普通人群HBV感染相似,而SLE的HBV感染明显低于RA患者和普通人群,SLE患者在使用糖皮质激素等免疫抑制剂时HBV感染风险不高,是否需要与RA一样常规推荐使用HBV疫苗、或HBV感染患者常规使用抗病毒药物,值得进一步研究。Objective To investigate the prevalence of hepatitis B virus（ HBV） infection in patients with systemic lupus erythematosus（ SLE） and rheumatoid arthritis（ RA）. Methods Totally 346 patients with SLE and 294 patients with RA were recruited from the Department of Rheumatology and Immunology in the First Affiliated Hospital of Anhui Medical University from January 2015 to December2015. Clinical and laboratory parameters such as HBV serological markers data were recorded. Results In the control group,the positive rates of HBs Ag,HBs Ab,HBe Ag,HBe Ab and HBc Ab were 6. 6%,59. 0%,0. 5%,8. 0% and 21. 2%,respectively. The positive rates of them in SLE group were 0. 6%,41. 3%,0. 0%,1. 4% and 2. 9%,respectively while the positive rates of them in RA group were 7. 1%,57. 8%,1. 0 %,6. 8% and 16. 3%,respectively. The prevalence of HBV infection in patients with RA was similar to that of normal population. All the indicators of HBV infection in patients with SLE were significantly lower than those in patients with RA（ P= 0. 001） and normal subjects. The indicators of HBV infection were not significantly associated with clinical parameters and autoantibody in patients with SLE and RA（ all P 〉0. 05）. Conclusions The prevalence of HBV infection in patients with SLE was lower than that of normal subjects and patients with RA. The prevalence of HBV infection in patients with RA was similar to that of normal subjects.. Further study will be needed of whether HBV vaccine should be routinely recommended or patients with HBV infection should use routinely antiviral drugs,when the use of glucocorticoid and immunosuppressant results in low prevalence of HBV infection.

关 键 词：乙型肝炎病毒 红斑狼疮 系统性 关节炎 类风湿 

分 类 号：R593.2[医药卫生—内科学] R512.62[医药卫生—临床医学]