乙型肝炎患者血清抗核抗体的研究

Serum antinuclear antibodies in patients with HBV

目的探讨乙型肝炎病毒(hepatitis B virus,HBV)感染与抗核抗体(antinuclear antibody,ANA)的相关性。方法收集2005～2010年本院传染科住院的146例HBV患者,检测患者的ANA阳性率,并将患者分为ANA阳性组和ANA阴性组,分析两组的性别和年龄分布情况,并对两组患者的谷丙转氨酶(alanine aminotransferase,ALT)、谷草转氨酶(aspartate aminotransferase,AST)及乙型肝炎病毒DNA(hepatitis B virus DNA,HBV-DNA)进行检测。结果与正常人相比,HBV患者的ANA总检出率较高,为27.4%;HBV患者中ANA阳性组年龄均主要集中在45～59年龄段,ANA阴性组患病年龄主要集中在15～44年龄段;ANA阳性组与阴性组的ALT和AST无统计学差异,而ANA阳性组HBV-DNA含量明显高于阴性组。结论 HBV感染可引发自身免疫性反应,导致抗核抗体的产生。这种自身免疫性反应与感染者的年龄、性别及病毒的复制水平有关。

Objective To explore the correlation between infection of hepatitis B virus（HBV） and antinuclear antibodies.Methods One hundred and forty-six HBV patients were collected from inpatients of Department of Infection,The First Affiliated Hospital of Harbin Medical University from 2005 to 2010.Patients were divided into ANA positive and ANA negative group.Sex and age distributions of these two groups of patients were analyzed.ALT,AST and HBV-DNA were examined.Results The positive rates of antinuclear antibodies were significantly higher in patients with HBV infection compared to those in normal control（27.4% vs 1.7%）;Age distribution of ANA positive group was mainly concentrated in the 45～59 age group,and age distribution of ANA negative group was mainly concentrated in the 15～44 age group;There was no significant difference in ALT and AST between ANA positive and ANA negative patients with HBV,but the titers of HBV-DNA of patients with positive ANA was significantly higher than patients with negative ANA.Conclusion HBV infection can induce autoimmune reactions,resulting in production of antinuclear antibodies.The autoimmune reaction has connection with sex,age and titers of HBV-DNA.