慢性乙型肝炎患者血清免疫学指标结果分析

Analysis of serum immune parameters of patients with chronic hepatitis B with different levels of hepatitis B viral load

目的对不同乙型肝炎病毒载量的慢性乙型肝炎患者的血清免疫指标进行结果分析,为临床提供更多的实验室信息,满足临床需求。方法使用实时荧光定量PCR仪检测120例临床已确诊的慢性乙型肝炎患者及40例健康体检者血清病毒拷贝数。将患者血清HBVDNA检测结果分为A、B、C3组,其中A组(40例):103～104copy/mL,B组(40例):105～106copy/mL,C组(40例):大于107copy/mL,健康对照组(40例):小于1.00×103copy/mL;采用免疫比浊法应用日立7600全自动生化分析仪分别检测每组血清免疫球蛋白(IgG、IgA、IgM)、补体(C3、C4)以及超敏C反应蛋白(hs-CRP)指标。结果结果显示3组(患者组)血清IgG、补体C3水平分别与健康对照组比较,差异有统计学意义(P<0.01);C组血清补体C4、hs-CRP水平与健康对照组比较差异有统计学意义(P<0.01或P<0.05);A组与C组间血清IgA水平比较差异有统学意义(P<0.05),其余组间比较差异无统计学意义(P>0.05)。结论血清IgG、补体C3指标可以作为反映肝脏损伤的敏感指标,将有助于临床诊断、治疗;通过患者组间比较发现血清免疫学指标的变化可能与乙型肝炎病毒载量的高低及肝组织损伤的严重程度无关,同时也为研究乙型肝炎的发病机制积累资料。

Objective To analyze the serum immune parameters of patients with chronic hepatitis B with different levels of hepatitis B viral load,provide more laboratories information for clinical and meet clinical needs. Methods The clinical diagnosis of 120 cases with chronic hepatitis B patients and 40 cases healthy people were reviewed,their HBV copy numbers were measured u- sing the Roche Lightcycler real-time fluorescence quantitative PCR Instrument. They were divided into A, B, C three groups according to serum HBV DNA test results,and the serum HBV DNA test results of healthy people were made as a normal control group： group A（40 cases） ： 10^3～10^4copy/mL,group B（40 cases） ： 10^5～10^6copy/mL, group C（40 cases） ： 〉 10^7 copy/mL, the normal control group （ 40 cases） ： 1.00×10^3copy/mL; Their serum immune globulin（ IgG, IgA, IgM）, complement （C3, C4） and high-sensitivity C-reactive protein（hsCRP）levels were measured using immunoturbidimetry by Hitachi 7600 automatic biochemistry analyzer. Results The results showed that serum IgG and complement C3 levels of three groups（patient group）have significant difference comparing with the normal control group（P〈0.01） ;Serum complement C4 and hsCRP levels of Group C have significant difference comparing with normal control group（P〈0.01 or P〈0.05） ;Serum IgA of group A and group C have significant difference（P〈0. 05） ; The remaining difference between the two groups was not statistically significant（P〈0.05）. Conclusion Serum IgG,complement C3 indicator can be used as a sensitive indicator of responding to liver injury and contribute to the clinical diagnosis and treatment. By comparison of between the patients groups we found that the changes in immune parameters were unrelated to the hepatitis B viral load and the level of liver tissue injury, which meanwhile would accumulate data for studing the pathogenesis of hepatitis B.