HBV感染的两种血清学模式患者肝损伤及体液免疫水平的比较

Investigation of serum protein electrophoresis and hepatic injury and humoral immunity in patients of two modes of infection of HBV

目的比较乙型肝炎病毒(Hepatitis B virus,HBV)感染HBsAg、HBeAg、HBcAb阳性(简称"HBeAg阳性"组)以及HBsAg、HBeAb、HBcAb阳性(简称"HBeAb阳性"组)患者血清蛋白电泳与肝损伤及体液免疫的水平。方法检测"HBeAg阳性"组、"HBeAb阳性"组及对照组肝功能、体液免疫水平,检测蛋白电泳及乙肝两对半定量,比较3组以上检测项目。结果患者组中自蛋白(ALB)条带均低于对照组,γ条带高于对照组(P均<0.05),"HBeAb阳性"组改变更为明显。患者组ALT、AST、同型半胱氨酸(HCY)的水平均显著高于对照组(P<0.01)。"HBeAg阳性"组血清中ALT、AST、HCY显著高于HBeAb阳性组,C_3、C_4、IgG、CRP水平的变化相反(P均<0.01)。结论患者组均可发生肝损伤,体液免疫较为亢进,血清蛋白电泳有所改变;"HBeAb阳性"组较"HBeAg阳性"组肝损伤、炎性反应更为严重。

Objective To investigate the levels of serum protein electrophoresis, hepatic injury and humoral immunity in two groups of patients infected with HBV. One group was HBeAg positive, and the other was HBeAb positive. Their data were compared with those in normal controls to test clinical significance. Methods Roche Cobas 6000 analyzer was used to measure the data on infection with HBV. Sebia high performance capillary electrophoresis technique was used for serum protein electrophoresis. Hitachi 7600 blood biochemical analyzer was used to obtain other related data. Results Compared with normal controls, the percentage of albumin was lowered and that of γ globulin was much raised（ P 〈 0.05 ）. The changes in the HBeAb positive group were more remarkable than those in the HBeAg positive group. The levels of ALT, AST and HCY in the two groups of patients were markedly increased （ P 〈 0.01 ）, and the levels of TP and ALB changed （P 〈 0. 05）. Compared with the HBeAb positive group , the levels of ALT, AST were much elevated in the HBeAg positive group, but the changes in C3 , C4, IgG and CRP were just the opposite （P 〈 0.01 ）. Conclusions Hepatic injury is present in HB~ - infected patients. Humoral immunity is accentuated , and there are some changes in the patients＇serum protein electrophoresis. The changes in the HBeAb positive group are more obvious than those in the HBeAg positive group , but the reactiveness of disease is more active in the HBeAg positive group.