论文部分内容阅读
目的探讨自身免疫反应在丙型肝炎病变过程中的作用和影响。方法采用间接免疫荧光法和免疫印迹法对129例丙型肝炎、25例自身免疫性肝炎及30例健康体检者血清中抗核抗体、抗线粒体抗体、抗可提取性核抗原抗体、抗肝抗原抗体进行检测;观察丙型肝炎病变及治疗前后的自身抗体的变化;探讨自身抗体与Hcv-RNA、肝功能指标之间的关系。结果丙型肝炎患者血清自身抗体总阳性率为44.19%,明显高于健康对照者(P<0.01),但低于自身免疫肝炎患者(P<0.01);自身抗体以单项和双项阳性及<1:160的低滴度抗体为主。丙型肝炎患者中,自身抗体总阳性率按照急性、慢性、丙型肝炎后肝硬化和丙型肝炎后原发性肝癌组依次升高,慢性丙型肝炎明显高于急性肝炎(P<0.05);丙型肝炎后肝硬化和丙型肝炎后原发性肝癌两组均高于慢性丙型肝炎(P<0.05),但两者之间差异无统计学意义(P>0.05)。自身抗体阳性的丙型肝炎患者丙氨酸氨基转移酶、门冬氨酸氨基转移酶、碱性磷酸酶、谷氨酰转肽酶等肝功能损害指标明显高于阴性患者(P<0.01)。结论自身免疫反应在丙型肝炎的发生、发展和转归过程中发挥了极为重要的作用。
Objective To investigate the role and influence of autoimmune reaction in the pathogenesis of hepatitis C (C). Methods The serum levels of antinuclear antibody, anti-mitochondrial antibody, anti-extractable anti-nuclear antigen antibody and anti-liver antigen in 129 patients with hepatitis C, 25 autoimmune hepatitis and 30 healthy controls were detected by indirect immunofluorescence and immunoblotting. Antibodies were detected; observation of hepatitis C lesions and changes before and after treatment of autoantibodies; autoantibodies and Hcv-RNA, the relationship between indicators of liver function. Results The positive rate of autoantibodies in patients with hepatitis C was 44.19%, significantly higher than that in healthy controls (P <0.01), but lower than that in patients with autoimmune hepatitis (P <0.01) 1: 160 low titer antibody based. In patients with hepatitis C, the total positive rate of autoantibodies increased in turn according to acute, chronic, hepatitis C post-cirrhosis and hepatitis C post-primary liver cancer group, and chronic hepatitis C was significantly higher than acute hepatitis (P <0.05) ; Posthepatitic cirrhosis and posthepatitic cirrhosis were higher than those in chronic hepatitis C (P <0.05), but there was no significant difference between the two groups (P> 0.05). Autoantibodies positive hepatitis C patients with alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, glutamyl transpeptidase and other indicators of liver function was significantly higher than negative (P <0.01). Conclusion The autoimmune reaction plays a very important role in the occurrence, development and prognosis of hepatitis C.