补体C3及C4评估自身免疫性肝炎病情的价值

Complement C3 and C4 level detection value in assessing disease condition of the patients with autoimmune hepatitis

目的评价补体c3、c4水平在自身免疫性肝炎（AIH）活动期中的应用价值。方法回顾性研究。收集2006至2009年北京佑安医院收治的AIH患者72例（活动期48例，缓解期24例），分析AIH患者外周血补体c3、c4水平与其肝脏炎症活动程度的关系。采用t检验、秩和检验、）（2检验进行统计学分析。结果AIH活动期患者外周血c3和C4水平[（0．88±0．04）g／L、（0．15±0．01）g/L]低于缓解期[（1．05±0．04）g／L、（0．21±0．01）g／L]，差异有统计学意义（t=2．743、4．756，P均〈0．01）；c3水平与天冬氨酸转氨酶（AST）、总胆红素（TBIL）、直接胆红素（DBIL）成负相关（r=-0．2560、-0．3948、-0．4112，P均〈0．05）。18例AIH活动期患者肝脏病理组织穿刺检查的HAI病理评分与c4水平成明显负相关（r：-0．5967，P〈0．001）。结论AIH活动期c3、c4水平下降，其变化可作为AIH患者活动期诊断的辅助指标。

Objective To study the complement C3 and C4 level application value in active autoinunune hepatitis activity. Methods Retrospective study was used in this study. The seventy-two patients with AIH enrolled in this study including 48 cases in activity stage and 24 cases in remission. These patients were diagnosed and treated in Beijing You＇ an hospital from 2006 to 2009 year. The relationship between the complement C3 and C4 level in serum of period blood and the liver inflammation activity was analyzed. T-test, rank sum test, X2 test was used for statistical analysis. Results The C3 and C4 level in active AIH group was （0. 88 ± 0. 04）g/L and （0. 15 ± 0. 01 ）g/L, respectively, which were lower than those in remission [ （ 1.05 ±0. 04） g/L, （0. 21 ±0. 01 ） g/L, respectivelyl and the difference was significant （t = 2. 743,4. 756, respectively, P 〈 0. 01 ）. There was negative relationship between C3 level and aspartate aminotransferase（ AST）, total bilirubin （Tbil） and directed bilirubin （ Dbil ） （ r = - 0. 2560, - 0. 3948, -0.4112, P 〈 0.05）. Eighteen AIH patients in active disease stage were performed live biopsy and evaluated liver inflammation activity degree with HAL There was a significantly negative relationship between C4 level and HAi （ r = - 0. 5967, P 〈 0. 001 ）. Conclusion The complement C3 and C4 level drop in active AIH and the alteration may serve as a kind of secondary indicators for diagnosing active AIH.