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慢性乙型肝炎患者自身免疫性抗体水平与肝纤维化指标及Th1/Th2细胞因子的关系
作者:刘炜1  龚玥2  尤德宏1 
单位:1. 无锡市第八人民医院 检验科, 江苏 无锡 214000;
2. 无锡市第五人民医院 检验科, 江苏 无锡 214000
关键词:慢性乙型肝炎 自身免疫性抗体 肝纤维化 细胞因子 
分类号:R575.1
出版年·卷·期(页码):2019·47·第二期(113-117)
摘要:

目的:探讨慢性乙型肝炎患者自身免疫性抗体检测的临床价值。方法:选取2014年3月~2017年3月收治的慢性乙型肝炎患者102例为观察组,另选同期健康体检者102例为对照组,对两组自身免疫性抗体进行检测,并对观察组自身免疫性抗体阳性及阴性患者肝功能、肝纤维化指标及细胞因子水平予以对比。结果:观察组自身免疫性抗体总阳性率为26.47%,与对照组3.92%比较,差异有统计学意义(P<0.05);观察组中,自身免疫性抗体阳性患者谷草转氨酶(AST)、谷丙转氨酶(ALT)水平与阴性患者比较,显著较高,总蛋白(TP)、白蛋白(ALB)水平与阴性患者比较,明显较低,差异有统计学意义(P<0.05);自身免疫性抗体阳性患者透明质酸酶(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)水平与阴性患者比较显著较高,差异有统计学意义(P<0.05);自身免疫性抗体阳性患者白介素-4(IL-4)、白介素-6(IL-6)、白介素-10(IL-10)水平与阴性患者比较显著较高,干扰素-γ(IFN-γ)与阴性患者比较明显较低,差异有统计学意义(P<0.05)。结论:慢性乙型肝炎患者存在自身免疫性抗体,其对肝纤维化指标及相关细胞因子有一定影响,对慢性乙型肝炎患者自身免疫性抗体进行检测,可为病情评估、预后判断提供参考。

Objective:To investigate the clinical value of autoimmune antibody detection in patients with chronic hepatitis B.Methods:A total of 102 patients with chronic hepatitis B who were admitted during March 2014 and March 2017 were selected as observation group,another 102 patients who receivedphysical examination during the same period were selected as control group.The two groups of autoimmune antibodies were tested andliver function, liver fibrosis indexes and cytokines levels were compared between autoimmune antibody positive and negative patients in the observation group.Results:The total positive rate of autoimmune antibodies in the observation group was 26.47%, compared with 3.92% in the control group,the difference being statistically significant(P<0.05).In the observation group, the levels of aspartate aminotransferase(AST) and alanine aminotransferase(ALT) in autoimmune antibody positive patients were significantly higher than those in the negative patients, and the total protein(TP) and albumin(ALB) levels were significantly lower than those in negative patients,the difference being statistically significant(P<0.05).The levels of hyaluronidase(HA), laminin(LN), type Ⅲ procollagen(PCⅢ), and type IV collagen(IV-C) in autoimmune antibody positive patients were significantly higher than those in the negative patients with statistically significant differences(P<0.05).The levels of interleukin-4(IL-4), interleukin-6(IL-6) and interleukin-10(IL-10) in autoimmune antibody positive patients were significantly higher than those in negative patients,and Interferon-γ(IFN-γ) was significantly lower than those in the negative patients, and the difference was statistically significant(P<0.05). Conclusion:Autoimmune antibodies exist in patients with chronic hepatitis B, which have a certain effect on liver fibrosis index and related cytokines. The detection of autoimmune antibodies in patients with chronic hepatitis B can provide reference for the evaluation of the condition and the judgement of prognosis.

参考文献:

[1] 赵洁慧.2015APASL/WHO慢性乙型肝炎防治指南速递[J].浙江医学,2015,37(12):1017-1018.
[2] 王波,丁楠,常波,等.乙型肝炎后肝硬化自身抗体检测及其对肝功能影响的研究[J].中国实验诊断学,2013,17(11):2022-2025.
[3] 中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2015更新版)[J].中华肝脏病杂志,2015,23(12):888-905.
[4] 严丽波,唐红.慢性乙型肝炎诊治进展和展望[J].实用医院临床杂志,2016,13(2):5-8.
[5] 徐春利.影响慢性乙型肝炎病毒感染者临床结局的病毒学因素研究进展[J].实用肝脏病杂志,2012,15(3):270-272.
[6] 纪翠霞,胡九东,邢练军,等.乙型肝炎慢性化机制的研究现状[J].临床肝胆病杂志,2012,28(2):149-152.
[7] 汪永强,周振忠,李婷,等.抗核抗体与免疫性肝病抗体对乙型肝炎患者预后与转归的意义[J].现代检验医学杂志,2014,29(1):141-143.
[8] 谭朝霞,唐玉兰,高燕,等.自身抗体在乙型病毒性肝炎和自身免疫性肝炎中的特点分析[J].第三军医大学学报,2016,38(15):1762-1766.
[9] 邹莉.乙型肝炎病毒感染者血清抗核抗体的研究[J].检验医学与临床,2013,10(10):1217-1218.
[10] 李小溪,李波,李筱涵,等.肝纤维化相关细胞因子的血清学检测对慢性乙型肝炎肝纤维化进程的诊断价值[J].现代生物医学进展,2014,14(16):3109-3111.
[11] 刘宁,徐杰,刘金花,等.慢性乙型肝炎、乙肝肝硬化、乙肝肝癌患者Th1/Th2型细胞因子水平变化研究[J].胃肠病学和肝病学杂志,2014,23(2):158-161.
[12] 王传敏,石庆凤,汤守兵,等.乙型肝炎患者血清IL-1β、γ-IFN、HA、LN和PCⅢ在肝炎肝纤维化时水平的变化及其意义[J].临床和实验医学杂志,2015,14(9):718-721.
[13] 赵磊,刘殿武,王俊英,等.乙型病毒性肝炎患者血清IFN-γ、IL-10、TGF-β1检测的临床意义[J].河北医药,2012,34(15):2245-2247.
[14] 何肖敏,李斯文,吕婷霞,等.血清自身抗体在乙肝肝纤维化分期中的诊断价值研究[J].临床和实验医学杂志,2016,15(7):632-636.
[15] JEARN L H,KIM T Y.The antiribosomal P antibodies really elicit autoimmune hepatitis?[J].Liver Int,2014,34(1):165-166.

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