不同ABO血型肝病患者的免疫功能状态研究

Study on Prevalence of Immune Function among Hepatopaths with different ABO Blood groups

目的分析不同ABO血型的各型肝病患者体液和细胞免疫指标改变状况,为慢性乙型肝炎的发病机理探讨和治疗学与预后判断提供可靠依据。方法应用免疫扩散和APAAP桥联酶标等方法,检测健康对照组(NC)500例、乙肝标志物阳性的各型肝病562例,其中急性肝炎(ASC)140例,慢性肝炎(CH)192例,肝炎后肝硬化(LC)160例,原发性肝癌(PHC)70例,分别测定血清免疫球蛋白IgG、IgM、IgA、IgD、IgE、补体C_3(C_3)、总补体(CH_(50))、循环免疫复合物(CIC)、E-玫瑰花环形成率(E-RFC)及T细胞亚群CD_4、CD_8及CD_4/CD_8的改变情况。结果健康人群ABO血型分布态势为A>O>B>AB,ASC组为B>O>A>AB,CH组为O>B>A>AB,LC组为B>O>AB>A,PHC组为AB>B>O>A,各肝病组与NC组相比,体液免疫指标改变明显,自ASC至PHC,IgE递增显著,IgD、IgG次之,PHC组C_3、CIC明显升高,ERF-C明显降低。AB血型的肝病IgG、IgE、C_3、CIC明显升高,E-RFC显著降低,AB血型的LC和PHC患者CD_4、CD_4/CD_8明显降低,与其他各血型组和NC组相比,有显著性差异(P<0.05)。结论在HBV感染者中,AB血型者易于发生LC和PHC,这一血型的肝病患者易于出现体液免疫功能亢进和细胞免疫功能不足。按ABO血型检测以上指标,对判断预后。合理选择治疗方案具有指导意义。

Objective To investigate the changes of humoral and cellular immunity markers in various liver diseases by ABO blood group in order to provide the reliable evidences for probing pathogenesis, treatment and predicting prognosis of type B chronic hepatitis.Methods The cases of 500 health men (NC) as controls, various acute and chronic liver diseases with the positive index of hepatitis B which include acute hepatitis (ASC) 140 cases, chronic hepatite (CH) 192 cases, post- hepatitis cirrhosis (LC) 60 cases primary hepatocellular carcinoma (PHC) 70 cases were examined by immune -spreading assay, APAAP immune - bridge assay and so on in the study, the changes of seminal IgG, IgM, IgA, IgD, IgE, complement C3 (C3), total complement (CH50), circulatory, immune complex (CIC), E - rosetter formation rate (E- REC) and T - lymphocyte subsets in the group of NC, ASC, CH, LC and PHC were investigated respective-ly.Results the prevalence of ABO blood type was A>O>B>AB, B>O>A>AB, O>B>A>AB, B>O>AB>A, AB> B> O > A in the health population, the group of ASC, CH, LC, PHC respectively, Compared to control group, the humoral immune markers of all groups of liver disease changed markedly, IgE increased apparently and IgG increased Secondly from ASC, CH, LC to PHC, meanwhile C3 and CIC increased obviously and E - RFC decreased obviously in the group of PHC.Compared to the group of other blood type increased markedly (P < 0.05), whose E - RFC decreased markedly (P< 0.05), CD4, CD4/CD8 of LC and PHC diseases with AB blood type also decreased markedly (P< 0.05) . Conclusion These findings showed that the patients with AB blood type are easy to suffer from LC and PHC in the HBV -infected population, who have got hyper- humoral immune function and hypo - cellular immune function easily.Monitoring the immune indexes discussed above by ABO blood type has significance in guiding the predicting prognosis and selecting logical treating schemes in the clinical treatment of all type liver diseases.