HBV持续感染患者血清ANA、免疫球蛋白和补体水平及其临床意义  

Levels and clinical significance of serum ANA,immunoglobulins and complements in patients with persistent HBV infection

作　　者：余卉 刘少平[2] 宁立芬 YU Hui;LIU Shaoping;NING Lifen(Department of Clinical Laboratory,Taikang Tongji(Wuhan)Hospital,Wuhan,Hubei 430000,China;Department of Clinical Laboratory,Tianmen Municipal First People′s Hospital,Tianmen,Hubei 431700,China;Department of Clinical Laboratory,Wuhan Municipal Hanyang Hospital,Wuhan,Hubei 430000,China)

机构地区：[1]泰康同济(武汉)医院检验科,湖北武汉430000 [2]天门市第一人民医院检验科,湖北天门431700 [3]武汉市汉阳医院检验科,湖北武汉430000

出　　处：《国际检验医学杂志》2021年第2期142-145,150,共5页International Journal of Laboratory Medicine

基　　金：湖北省卫生健康委员会课题(WJ2019H215)。

摘　　要：目的探讨外周血抗核抗体(ANA)、免疫球蛋白和补体在乙型肝炎病毒(HBV)持续感染患者中的水平及意义。方法将92例HBV感染患者分为慢性乙型肝炎(CHB)组27例和肝硬化组65例,另选健康体检者60例为对照组,比较3组ANA、免疫球蛋白和补体水平,分析CHB患者发生肝硬化的危险因素,探讨各指标的诊断价值。结果各组血清IgG、IgA、IgM、C3和C4水平差异有统计学意义(P<0.05);肝硬化组、CHB组、对照组ANA阳性率分别为40.74%、21.54%和5.00%(P<0.05)。ANA阳性、IgG和IgA均为HBV感染患者发生肝硬化的独立危险因素(P<0.05),C3和C4则为肝硬化的重要保护因素(P<0.05)。ANA、IgA、C3及3项指标联合检测诊断肝硬化的灵敏度分别为40.74%、74.07%、70.37%和66.67%,特异度分别为80.00%、84.62%、81.54%和95.38%。结论HBV持续感染患者外周血ANA、免疫球蛋白和补体水平明显升高,且与患者肝硬化关系密切,可为肝硬化早期诊断和治疗提供参考依据。Objective To study the expression levels and significance of peripheral blood antinuclear antibody(ANA),immunoglobulins and complements in the patients with persistent hepatitis B virus(HBV)infection.Methods Ninety-two patients with HBV infection were divided into the chronic hepatitis B(CHB)group(27 cases)and liver cirrhosis group(65 cases),and other 60 subjects undergoing the healthy physical examination were selected as the control group.The expression levels of ANA,immunoglobulins and complements were compared among the three groups,and the risk factors of liver cirrhosis occurrence in the patients with CHB were analyzed and the diagnostic value of each index was analyzed.Results There were statistically significant differences in the levels of serum IgG,IgA,IgM,C3 and C4 among various group(P<0.05).The positive rates of ANA in the liver cirrhosis group,CHB group and control group were 40.74%,21.54%and 5.00%respectively(P<0.05).Positive ANA,IgG and IgA were the independent risk factors for liver cirrhosis occurrence in the patients with HBV infection,while C3 and C4 were the important protective factors for cirrhosis(P<0.05).The sensitivities of ANA,IgA,C3 and combined detection of these 3 indicators in the diagnosis of liver cirrhosis were 40.74%,74.07%,70.37%and 66.67%respectively,and the specificities were 80.00%,84.62%,81.54%and 95.38%respectively.Conclusion The levels of peripheral blood ANA,immunoglobulins and complements in the patients with persistent HBV infection are significantly increased,moreover are closely related to liver cirrhosis,which can provide the reference basis for early diagnosis and treatment of liver cirrhosis.

关 键 词：乙型肝炎病毒 持续感染 抗核抗体 免疫球蛋白 补体 

分 类 号：R446.1[医药卫生—诊断学] R512.62[医药卫生—临床医学]