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目的:研究人静脉丙种球蛋白(IVIG)治疗对患者乙型肝炎检测的影响。方法:回顾分析原发性免疫性血小板减少症患者病例,分析乙型肝炎检测中抗HBe抗体(anti-HBeAb)阳性和(或)抗HBc抗体(anti-HB-cAb)阳性的非乙型肝炎患者的治疗情况。结果:Anti-HBeAb和(或)anti-HBcAb阳性的53例患者中有50例(94.3%)使用了IVIG,其余3例(6.7%)从未用过IVIG。2例患者用IVIG前乙型肝炎标志物检测为阴性,IVIG使用后,检测显示anti-HBeAb和(或)anti-HBcAb阳性。IVIG暴露患者在治疗后anti-HBeAb和(或)anti-HB-cAb阳性组显著多于anti-HBeAb和anti-HBcAb阴性组,经χ2检验,P<0.01;经Fisher精确检验,P<0.05。Anti-HBeAb阳性组,IVIG暴露患者显著多于无IVIG暴露患者(P<0.01)。Anti-HBcAb阳性组,IVIG暴露患者显著多于无IVIG暴露患者(P<0.01)。结论:IVIG治疗可能影响乙型肝炎标志物检测结果,可能造成乙型肝炎标志物检测结果的误判。
Objective: To study the effect of intravenous gamma globulin (IVIG) treatment on hepatitis B in patients. Methods: A retrospective analysis of patients with idiopathic thrombocytopenia was performed to analyze anti-HBe-positive and / or anti-HB-cAb-positive non-hepatitis B in hepatitis B testing Patient’s treatment. Results: Of the 53 patients with anti-HBeAb and / or anti-HBcAb positive, IVIG was used in 50 (94.3%) and IVIG was never used in the remaining 3 patients (6.7%). Two patients were negative for a pre-IVIG marker of hepatitis B and tested positive for anti-HBeAb and / or anti-HBcAb after IVIG administration. The levels of anti-HBeAb and / or anti-HB-cAb in IVIG-exposed patients were significantly higher than those in anti-HBeAb and anti-HBcAb-negative groups after treatment, P <0.01 byχ2 test; P <0.05 by Fisher’s exact test. Anti-HBeAb positive group, IVIG exposure were significantly more than those without IVIG exposure (P <0.01). Anti-HBcAb positive group, IVIG exposure were significantly more than those without IVIG exposure (P <0.01). Conclusion: IVIG treatment may affect the detection of hepatitis B markers, which may lead to the misjudgment of hepatitis B markers.