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目的探讨慢性丙型肝炎(CHC)合并冷球蛋白血症患者血清自身抗体检出率与其临床意义。方法选取2014年12月—2016年12月信阳职业技术学院附属医院92例CHC患者,依据是否检出血清冷球蛋白将其分为观察组(检出血清冷球蛋白)44例,与对照组(未检出血清冷球蛋白)48例,检测比较两组血清丙型肝炎病毒定量(HCV-RNA)、抗平滑肌抗体(anti-SMA)、抗肝肾微粒体抗体(anti-LKM)、抗线粒体抗体(antiAMA)、抗核抗体(ANA)水平并观察自身抗体不同患者的临床特征。结果观察组血清anti-SMA、ANA检出率及总检出率分别为22.73%、40.91%、79.35%,均高于对照组4.17%、18.75%、29.17%,差异有统计学意义(P<0.05);观察组自身抗体检测阳性者谷丙氨酸转氨酶(ALT)、总胆红素(TBil)水平均高于阴性者,差异有统计学意义(P<0.05);对照组自身抗体检测阳性者ALT高于阴性者,差异有统计学意义(P<0.05)。结论CHC合并冷球蛋白血症患者具有较高血清自身抗体检出率,且肝功能损伤较严重。
Objective To investigate the detection rate of serum autoantibodies in patients with chronic hepatitis C (CHC) complicated with cryoglobulinemia and its clinical significance. Methods From December 2014 to December 2016, 92 patients with CHC in the Affiliated Hospital of Xinyang Polytechnic were enrolled and divided into observation group (serum cryoglobin) 44 cases and control group (Serum cryoglobulin was not detected) 48 cases were detected and compared between the two groups of serum HCV-RNA, anti-SMA, anti-LKM, AntiAMA, ANA and observed the clinical features of different patients with autoantibodies. Results The detection rates of anti-SMA and ANA in the observation group were 22.73%, 40.91% and 79.35%, respectively, which were significantly higher than those in the control group (4.17%, 18.75%, 29.17%, P < 0.05). The levels of ALT and TBil in the test group were significantly higher than those in the negative group (P <0.05), and the level of autoantibodies in the control group was positive ALT higher than negative, the difference was statistically significant (P <0.05). Conclusions CHC patients with cryoglobulinemia have higher detection rate of serum autoantibodies and severe liver damage.