TPOAbIgG亚型在慢性丙型肝炎抗病毒治疗中的分布及其意义  

Distribution of IgG Subclasses of TPOAb in Sera form Chronic Hepatitis C Patients Treated with Peg-IFNa-2a and Ribavirin

作　　者：孙岩[1] 姚红[1] 樊健[1] 程昱[1] 卢宝玲[1] 钟丽华[1] 于雷[1] 朱丽影[1] 

机构地区：[1]哈尔滨医科大学附属第四医院,黑龙江哈尔滨150001

出　　处：《现代生物医学进展》2017年第1期162-165,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨甲状腺功能正常但甲状腺过氧化物酶抗体(TPOAb)阳性的慢性丙型肝炎(CHC)患者干扰素治疗前后血清中TPOAb Ig G1、Ig G2、Ig G3、Ig G4的分布及其意义。方法:收集甲状腺功能正常但TPOAb阳性的CHC患者46例,按应用聚乙二醇干扰素(Peg-IFNα-2a)联合利巴韦林(RBV)抗病毒治疗过程中甲状腺功能(包括FT3、FT4、TSH)情况分为正常组和异常组。采用酶联免疫吸附测定法(ELISA)检测治疗前后患者血清中TPOAb Ig G各亚型的百分结合率,比较两组患者治疗前后TPOAb Ig G亚型的变化,进而分析该变化与合并甲状腺功能异常的相关性。结果:146例TPOAb阳性的CHC患者治疗过程中甲状腺功能异常者为35例,占76.09%,其中甲状腺功能减退(甲减)19例,占41.30%,甲状腺功能亢进(甲亢)3例,占6.52%,亚临床甲减12例,占26.09%,亚临床甲亢1例,占2.17%。2异常组抗病毒治疗前后TPOAb Ig G2亚型阳性率均高于正常组(P值分别为0.005和0.036),TPOAb Ig G1、Ig G3、Ig G4阳性率在正常组和异常组间的差异均无统计学意义(P>0.05)。结论:伴TPOAb阳性CHC患者应用干扰素治疗前检测其血清中TPOAb Ig G2亚型可预示抗病毒治疗过程中甲状腺功能异常,尤其是甲减及亚临床甲减发生的可能性,有助于指导临床监测和及时检出甲状腺功能异常。Objective： To analyze chronic hepatitis C（CHC） and thyroid peroxidase antibody（TPOAb） positive and euthyroidism patients antiviral treatment occured the frequency thyroid dysfunction, and its relationship with IgG1、IgG2、IgG3、IgG4 of TPOAb.Methods： A total of 46 CHC and TPOAb positive and euthyroidism patients were treated with peg-IFNa-2a and RBV for 48 weeks and post-treatment week 24 of follow-up. When thyroid function（FT3, FT4, TSH）by the end of treatment were divided into normal group and abnormal group. IgG subclasses of TPOAb were detected by antigen-specific enzyme-linked immunosorbent assay（ELISA）. IgG subclasses of TPOAb positive comparison with two group, and its relationship with thyroid dysfunction at before and after antiviral treatment. Results： 1Thirty-five（76.09%） of 46 treated patients developed thyroid dysfunction. Dysfunction severity ranged from hypothyroidism（n=19, 21.60%）and hyperthyroidism（n=3, 6.52%）to subclinical hypothyroidism（n=12, 26.09%）and subclinical hyperthyroidism（n=1, 2.17%）. 2Abnormal group TPOAb IgG2 positive rate is significantly higher than normal group at before and after antiviral treatment.（ P=0.005, 0.036）. Conclusion： At before antiviral treatment CHC and TPOAb positive patients TPOAb IgG2 positive might predict thyroid dysfunction especially hypothyroidism and subclinical hypothyroidism in antiviral treatment,that guides clinical monitoring and detection of thyroid dysfunction.

关 键 词：慢性丙型肝炎 干扰素 甲状腺过氧化物酶抗体 亚型 

分 类 号：R512.6[医药卫生—内科学]