乙肝病毒感染与抗中性粒细胞胞浆抗体相关性分析

The correlation of HBV infection and antineutrophil cytoplasmic antibody

目的探讨乙肝患者病毒复制活动情况与血清抗中性粒细胞胞浆抗体(ANCA)的相关性。方法回顾性分析浙江大学医学院附属第一医院近三年来慢乙肝患者临床资料,排除并发自身免疫性肝病、酒精性肝病、药物性肝病等其他肝病和并发其他病毒感染,完善ANCA检测,共有21例患者纳入。根据乙肝患者入院后检测HBV DNA的拷贝水平,将患者分为HBV复制活动组和合HBV复制非活动组,根据ANCA检出情况又可分为ANCA阳性组和阴性组。采用实时荧光定量PCR检测HBVDNA拷贝水平,间接免疫荧光方法检测血清ANCA水平。结果 21例患者中,HBV复制活动组(11例)中pANCA阳性患者6例(55.5%),而HBV复制非活动组(10例)中pANCA阳性患者0例(0%)(χ2=5.198,P=0.023)。pANCA阳性组(6例)中HBV复制活动患者6例(100%),而pANCA阴性组(15例)中HBV复制活动患者5例(33.3%)(χ2=5.198,P=0.023)。而两组患者中肝硬化患者、原发性肝癌患者和ABO血型检测差异无统计学意义(P>0.05)。结论乙肝病毒活动可能引起血管损害,同时乙型肝炎病毒引起的血管损害并不一定增加肝硬化和肝癌的发生。

Objective To study the correlation of HBV infection and antineutrophil cytoplasmic antibodies（ANCAs）.MethodsWe reviewed the medical records of patients with HBV infection in recent three years in our hospital.All the patients were divided into HBV infection group and a control group based on the level of HBV DNA copies.The patients were divided into pANCA positive group and negative group based on the tests of pANCA.HBV DNA levels were detected by real-time quantitative PCR and ANCAs were detected by indirect immunofluorescence method.Results Comparing the two groups of patients based on HBV DNA levels,the pANCA positive rate was 55.5% in the infection group and zero in control group（χ2=5.198,P=0.023）.The HBV DNA positive rate was 100% in pANCA positive group,and 33.3% in pANCA negative group（χ2=5.198,P=0.023）.The differences in ABO blood types,cirrhosis with Hepatitis B and cancer between the two groups had no statistical significance（P0.05）.Conclusions Hepatitis B virus activity may cause vascular damage,which is not necessarily correlated with the increased incidence of cirrhosis and liver cancer.