系统性红斑狼疮患者乙型肝炎病毒感染状态分析  

Analysis of hepatitis B virus infection status in patients with systemic lupus erythematosus

作　　者：张靖婧 贾悦 莫凌菲[1] 王妍华[1] 罗静[1] 胡楠 何岚[1] 王静[1] Zhang Jingjing;Jia Yue;Mo Lingfei;Wang Yanhua;Luo Jing;Hu Nan;He Lan;Wang Jing(Department of Rheumatology and Immunology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院风湿免疫科,西安710061

出　　处：《中华风湿病学杂志》2022年第3期175-178,共4页Chinese Journal of Rheumatology

摘　　要：目的探讨SLE对乙型肝炎病毒(HBV)感染状态的影响,为明确自身免疫与感染的关系提供数据。方法连续筛选2016年1月至2019年12月就诊于西安交通大学第一附属医院风湿免疫科SLE患者,调查的乙型肝炎病毒表面抗原(HBsAg)及乙型肝炎病毒核心抗体(HBcAb)阳性率。采用病例对照研究按1∶4纳入与HBsAg阳性SLE患者性别、年龄匹配的一般慢性乙型肝炎患者,采用χ^(2)检验比较乙型肝炎病毒e抗原(HBeAg)阳性率的差异,配对t检验或秩和检验比较HBV-DNA载量及HBsAg滴度的差异。结果SLE患者的HBsAg阳性率为2.2%(27/1227),低于2006年我国第二次全国流调中一般人群HBsAg流行率7.2%,但HBcAb阳性率与我国一般人群差异不大[33.9%(416/1227)和34.1%]。SLE患者与匹配的慢性乙型肝炎患者相比,HBeAg阳性率[37.0%(10/27)和58.3%(63/108),χ^(2)=3.94,P=0.047]、HBV-DNA载量[0(0,3.7)lg U/ml和4.8(2.2,3.7)lg U/ml,Z=-5.37,P<0.001]及HBsAg滴度[(2.0±1.5)lg U/ml和(3.3±1.1)lg U/ml,t=-4.26,P<0.001]均更低。结论SLE患者的HBV感染状态不同一般慢乙型肝炎患者,更倾向于HBV的控制。Objective To investigate the effect of systemic lupus erythematosus(SLE)on the status of hepatitis B virus(HBV)infection,and provide data for clarifying the relationship between autoimmunity and infection.Methods SLE patients in the department of rheumatology and immunology of the First Affiliated Hospital of Xi'an Jiaotong University from January 2016 to December 2019 were screened.A retrospective case-control study was carried out.SLE patients with positive hepatitis B surface antigen(HBsAg)were gender and age matched with chronic hepatitis B(CHB)in a 1∶4 ratio.Chi-square test was used to compared the positive rates of hepatitis B e antigen(HBeAg)and Paired-Samples t test or Signed rank Wilcoxon test was used to compare the HBV DNA load and HBsAg titer.Results The positive rate of HBsAg in SLE patients was lower than the prevalence rate of HBsAg in general population in the second Chinese National Hepatitis Seroepidemiological Survey in 2006[2.2%(27/1227)vs 7.2%],but the positive rate of HBcAb was not obviously different from that in general population in China[33.9%(416/1227)vs 34.1%].Compared with matched CHB patients,the positive rate of HBeAg[37.0%(10/27)vs 58.3%(63/108),χ^(2)=3.94,P=0.047],the HBV DNA load[0(0,3.7)lg U/ml vs 4.8(2.2,3.7)lg U/ml,Z=-5.37,P<0.001]and HBsAg titer[(2.0±1.5)lg U/ml vs(3.3±1.1)lg U/ml,t=-4.26,P<0.001]in SLE patients were lower.Conclusion The HBV infection status of SLE patients is different from that of patients with chronic hepatitis B and the HBV infection is more likely to be controlled.

关 键 词：红斑狼疮 系统性 乙型肝炎病毒 乙型肝炎表面抗原 乙型肝炎抗体 

分 类 号：R512.62[医药卫生—内科学] R593.241[医药卫生—临床医学]