慢性嗜肝病毒感染者血清类风湿因子的检测及临床意义

Significance of detection of serum rheumatoid factor in chronic hepatitis patients with hepatotropic virus infection

目的 探讨慢性嗜肝病毒感染者血清类风湿因子（RF）检测的临床意义。方法 选取2011-2013年延安大学附属医院门诊及住院慢性乙型肝炎病毒感染者190例,慢性丙型肝炎病毒感染者50例,健康对照组50例,联合检测乙肝病毒DNA定量、乙肝系列定量、谷丙转氨酶、谷草转氨酶、总胆红素、抗丙肝病毒抗体、丙肝病毒RNA定量,类风湿因子,对不同组检测结果进行差异性统计分析。结果 慢性乙型肝炎病毒感染者、慢性丙型肝炎感染者、健康对照组的RF阳性率分别为26.32%、60.00%和4.00%,三组间比较差异有统计学意义,慢性丙型肝炎病毒感染者RF阳性率最高。慢性嗜肝病毒感染者家族史阳性与家族史阴性组间RF阳性率差异无统计学意义,不同性别之间RF阳性率差异有统计学意义,不同年龄组之间RF阳性率差异有统计学意义,肝功正常与肝功异常组之间RF阳性率差异有统计学意义。结论 类风湿因子阳性率可以从不同侧面反映不同嗜肝病毒感染者机体免疫紊乱的不同状况和肝功情况,动态监测RF的变化,可以更加全面的了解慢性嗜肝病毒感染者机体免疫状况,有助于对慢性嗜肝病毒感染者病情的全面评估和合理有效治疗方案的制定。

Objective To analyze the clinical significance of detection of serum rheumatoid factor in chronic hepatitis patients with hepatotropic virus infection. Methods The 190 chronic hepatitis B patients,50 chronic hepatitis B patients and 50 healthy controls were selected from the affiliated Hospital of Yan＇an university, and parameters of hepatitis B virus DNA, hepatitis B virus series, alanine aminotransferase,aspartate aminotransferase, total bilirubin, hepatitis C virus RNA,anti -HCV antibody and rheumatoid factor （RF）were detected. The data were analyzed.Results The positive rate of RF in chronic hepatitis B cases, chronic hepatitis C cases healthy control group were 26.32%, 60.00% and 4.00%, exhibiting significant differences among the three groups. The positive rate of RF in chronic hepatitis C cases was the highest. The positive rate of RF showed no significant differences between the positive family history group and family history negative group. Significant differences in positive rates of RF were also noticed between male and female hepatitis cases, between different age groups and between cases with normal hepatic function and abnormal hepatic function. Conclusion The positive rate of RF correlated with age, gender, immune status and hepatic function of the patients. Dynamic monitoring of the level of RF allows overall understanding the immune condition of the patients with hepatotropic virus infection, thus conducive to the comprehensive assessment and making adequate approach for treatment of the infections.