首页> 中文期刊> 《现代检验医学杂志》 >丙型肝炎患者自身抗体检出率、丙肝病毒载量及肝功能间的相关性

丙型肝炎患者自身抗体检出率、丙肝病毒载量及肝功能间的相关性

         

摘要

Objective To analyze the correlation between the positive rate of autoantibody and hepatitis C virus load and the relationship between the positive incidence and the status of liver function in patients infected HCV.Methods 168 patients infected hepatitis C virus were included,to detect serum autoantibody,HCV loads and liver function file.And 129 healthy controls were collected to test the serum autoantibody.Using the Chi-square test to analyze the count data,and performing student test or Nonparametric test to study measurement data,compared the positive rate of autoantibody in patients with HCV and that in healthy controls.Analyzed the correlation among the positive incidence of autoantibody,HCV load and the status of liver function in patients infected HCV,and studied the relationship of the positive rate of autoantibody with age and also with gender of the patients.Results The positive rate of autoantibody in patients with HCV was 35.12%(59/168),in which ANA accounted for 33.93%,SMA took up 2.98%,AMA-M2 made up 1.80% and anti-LKM1 1.20%.No patient existed LC-1 or SLA/LP in his/her serum.The total positive rate of autoantibody and ANA both were higher in pa-tients than in healthy controls (χ2=23.179,P=0.000;χ2=21.360,P=0.000).There existed no significant difference in the levels of HCV load,total bilirubin (TBil),ALT and AST between the patients whose autoantibody examinations were positive and those who were negative in autoantibody test (χ2=0.113,P=0.945;Z=-1.087,P=0.277;Z=-1.356,P=0.175;Z=-0.153,P=0.878).The positive rate of autoantibody not correlated with the gender (χ2=2.897,P=0.089), but related to the age (t=3.274,P=0.001)of the patients.There existed significant difference in the levels of ALT,AST and the age between the patients HCV RNA negative and those HCV RNA positive (Z=-6.430,P=0.000;Z=-6.123, P=0.000;t=-3.152,P=0.002),and the patients whose HCV RNA were negative younger than those who with HCV RNA positive (44.17 vs 55.27 years).Conclusion It is easy for autoimmunity to occur on persons infected HCV.The posi-tive rate of autoantibody is related to patients’age,but not to the HCV amount in patients.Besides,it cannot predict the sta-tus of the patients’liver injury that weather the autoimmunity appears.But HCV load correlated with patients'age and liver inj ury,which older group patients bring higher virus load and had more serious liver damage.%目的研究丙型肝炎患者自身抗体检出率、丙肝病毒(HCV)载量及肝功能三者之间的相关性。方法检测168例丙肝患者自身抗体、丙肝病毒载量以及肝功能结果,并选取和检测129例健康对照者的自身抗体,其中计数资料采用卡方检验、计量资料采用t检验或者非参数秩和检验,统计分析丙肝患者与健康对照组自身抗体检出率差异,分析丙肝患者中自身抗体、病毒载量以及肝功能三者间的相关性,并分析自身抗体检出率与患者年龄、性别的关系。结果丙肝患者自身抗体阳性检出率为35.12%(59/168),各抗体阳性率分别为:抗核抗体(ANA)33.93%,抗平滑肌抗体(SMA)2.98%,抗线粒体 M2抗体(AMA-M2)1.80%,抗肝肾微粒体抗体(anti-LKM1)1.20%。抗胞浆抗体和抗可溶性肝抗原抗体未检出阳性。丙肝患者自身抗体总检出率及抗核抗体检出率较健康对照组高(χ2=23.179,P=0.000;χ2=21.360,P=0.000)。丙肝患者中,自身抗体阳性组与阴性组间丙肝病毒载量、总胆红素、谷氨酸氨基转移酶以及天冬氨酸氨基转移酶水平差异无统计学意义(χ2=0.113,P=0.945;Z=-1.087,P=0.277;Z=-1.356,P=0.175;Z=-0.153,P=0.878);自身抗体检出率与性别无关(χ2=2.897,P=0.089),而与年龄相关(t=3.274,P=0.001)。HCV RNA阴性组与阳性组间谷氨酸氨基转移酶、天冬氨酸氨基转移酶水平以及年龄的差异具有统计学意义(Z=-6.430,P=0.000;Z=-6.123,P=0.000;t=-3.152,P=0.002),HCV RNA阴性组年龄低于阳性组(44.17岁 vs 55.27岁)。结论丙肝患者容易发生自身免疫,自身抗体的产生与年龄有关,而与体内丙肝病毒载量的高低无关,也不能预测患者的肝功能损伤情况。HCV载量与患者年龄及肝损伤相关,高龄组病毒载量较高,肝损伤较严重。

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