乙型病毒性肝炎患者抗心磷脂抗体检测的临床意义

Hepatitis B patients with anti-cardiolipin antibodies and its clinical significance

目的:检测乙型病毒性肝炎患者血清抗心磷脂抗体(ACA)水平,探讨ACA与乙型病毒性肝炎发生发展的关系。方法:用ELISA法对所有被检者进行ACA(IgGI、gAI、gM)检测,计算各组ACA结合指数及阳性率。结果:乙型病毒性肝炎ACA-IgG和ACA-IgM阳性率显著高于正常对照组(P<0.01);重型肝炎患者在治疗后最终死亡的病例中,ACA阳性率为94.4%,高于最终存活者的81.8%,两者差异有显著意义(P<0.05);重型肝炎和肝炎后肝硬化患者中年龄在30岁以下的8例患者ACA均阳性;61例慢性肝炎患者中,ACA阳性的42例患者有11例分别于15～36个月发展为肝硬化,而ACA阴性的19例患者无肝硬化病例出现。结论:乙型病毒性肝炎患者ACA阳性率明显升高。提示ACA参与了乙型病毒性肝炎的发病过程,两者之间密切相关;乙型肝炎的病情发展及严重程度与ACA含量高低有关,阳性率越高,病情越严重,发展为肝硬化的可能性越高,死亡危险越大;年龄偏轻的乙型肝炎患者的发病可能有ACA这一致病因素的参与,对年轻患者应追踪检测ACA;对慢性肝炎是否发展为肝硬化,ACA有一定的预测价值,可提前干预治疗。

Objective：To explore the hepatitis B patients with serum anti-cardiolipin antibodies（ACA） levels of ACA and the relationship between the developments of hepatitis B virus.Methods：By ELISA method were all seized by ACA（IgG,IgA,IgM） detection,with each group index and the positive rate of ACA.Results： Hepatitis B ACA-IgG and ACA-IgM positive rate was significantly higher than the control group（P0.01）;After treatment in patients with severe hepatitis and died in the end,ACA-positive rate was 94.4%,higher than 81.8% of the ultimate survivors,there was a significant difference between the two（P0.05）;Severe hepatitis and liver cirrhosis patients below the age of 30 ACA were positive in 8 patients;61 patients with chronic hepatitis patients,ACA were positive in 42 cases,11 patients were in 15-36 months,the development of cirrhosis,and The ACA-negative patients without liver cirrhosis in 19 cases of the disease.Conclusions： Hepatitis B patients with ACA;positive rate was increased.Tip ACA involved in the pathogenesis of hepatitis B virus,closely related between the two;Hepatitis B disease development and severity level of ACA content related to the higher positive rate,the more serious condition,the higher the likelihood of developing cirrhosis of the liver,the greater the risk of death;The lighter the age incidence of hepatitis B patients may be the pathogenic factors involved in ACA for young patients should follow detection ACA;Whether the development of chronic hepatitis to cirrhosis,ACA has some predictive value,of the earliest intervention.