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-现代医学

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

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

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.

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