慢性丙型肝炎患者自身抗体检测的临床意义

Clinical significance of auto-antibodies detection and measurement for patients with chronic hepatitis C

目的探讨慢性丙型肝炎患者自身抗体检测的临床意义。方法应用免疫荧光法(IIF)检测230例慢性丙型肝炎患者血清中自身抗体,并研究自身抗体与HCV RNA、肝硬化发生率、年龄、性别以及和ALT的关系。结果 230例慢性丙型肝炎患者中有95例至少有1项自身抗体阳性,总阳性率为41.5%,明显高于健康对照组2.5%,两组比较P<0.01,差异有统计学意义。HCV RNA阳性组与HCV RNA阴性组自身抗体的检出率差异显著(P<0.05)。自身抗体阳性组中丙型肝炎肝硬化发生率(65/95,68.4%)明显高于自身抗体阴性组(46/125,36.8%)。而且年龄≥40岁以上的患者发生肝硬化率更高,两组间比较,P<0.05,差异有统计学意义。结论慢性丙型肝炎患者中较为普遍存在自身免疫现象,且自身抗体的检出率与患者的年龄和肝硬化发生率明显相关,在丙型肝炎的常规诊疗中应加强检测自身抗体,对于慢性丙型肝炎患者的治疗具有较强的指导意义。

Objective To study the clinical significance of antibody detection for patients with chronic hepatitis C. Methods For 230 cases of chronic hepatitis C patients, detect serum auto-antibodies using indirect immunofluoresceuce（llF） method, and compare the results with the HCV RNA, cirrhosis incidence, age, gender, and ALT. Results Out of the 230 cases of chronic hepatitis C patients, 95 cases showed at least one autoantibody positive, the total positive rate was 41.5%, significantly higher than the healthy control group （2.5%, P〈0.01）. There was significant difference （P〈0.05） in detection rate of auto-antibodies between HCV RNA-positive group and HCVRNA-negative group. Hepatitis C cirrhosis incidence in autoantibody-positive group （65/95, 68.4%） was significantly higher than that in autoantibody-negative patients （46/148, 36.8%）（P〈0.01）. The proportion of patients 〉40 years old was significantly higher in autoantibody-positive group than in autoantibody-negative group （P〈0.05）. Conclusions Autoimmune phenomena is highly prevalent in patients with chronic hepatitis C, the detection of auto-antibodies is significantly associated with the patient＇s age and cirrhosis incidence. The detection and measurement of auto-antibodies and their titer in the conventional treatment holds important guiding meaning for the diagnosis and treatment of chronic heoatitis C oatients.