HBV抗原在乙型肝炎肝硬化患者脑组织中的表达及意义

Expression of hepatitis B virus antigen in brain tissue from liver cirrhosis patients with hepatitis B and its significance

目的 探讨乙型肝炎肝硬化患者脑组织中乙型肝炎病毒 (HBV)感染的状况及意义。方法 应用免疫组织化学链霉菌亲生物素蛋白 过氧化物酶连接法 (S P法 )对 70例乙型肝炎肝硬化死亡患者脑组织进行了HBsAg、HBcAg检测 ,分析HBV抗原的表达与临床、病理的关系。结果 HBV抗原患者 30例 (4 2 89% ) ,其中HBsAg阳性 2 4例 (34 2 9% ) ,HBcAg阳性 18例 (2 5 71% )。抗原主要定位于细胞质 ,分布于神经元、神经胶质细胞及血管内皮细胞内。阳性细胞呈单个、散在或灶性、小片状分布。HBV抗原的表达与血清HBV水平无关 ,而与肝性脑病 (HE)的有无及HE患者脑组织病理损害的程度相关。结论 乙型肝炎肝硬化患者脑组织中存在HBV感染 ,并可能存在复制。脑组织中HBV感染 ,可能对乙型肝炎肝硬化患者HE的发生发展具有重要作用。

Objective To investigate the expression of hepatitis B virus (HBV) antigen in brain tissue from liver cirrhosis patients with hepatitis B and explore its significance.Methods HBsAg and HBcAg were detected in the brain tissue from 70 liver cirrhosis dead patients with hepatitis B by S P immunohistochemical assay,and the relationship between the expression of HBV antigen in brain tissue testing and clinic and pathology was analyzed.Results 30 patients (42.89%) were positive for HBV antigen. Among them, 24 patients (34.29%) were positive for HBsAg and 18 patients (25.71%) were positive for HBcAg. HBV antigen was mainly found in cytoplasm and distributed in neurons, neurogliocytes and vascular endothelial cells. The positive cell were distributed separately, scatteredly or focally. The expression of HBV antigen was not associated with the serum level of HBV replication but associated with the occurrence of hepatic encephalopathy (HE) and the severity of brain tissue pathyologic lesions of HE.Conclusion The results indicate that HBV infection develop in brain tissue from liver cirrhosis patients with hepatitis B and HBV may replicate in it.HBV infection in brain tissue may play an important role in occurrence and development of HE from liver cirrhosis patients with hepatitis B.