深圳市乙肝患者不同感染模式的免疫状况分析

Analysis of the immune status of hepatitis B patients with different infection patterns in Shenzhen city

目的探讨深圳市乙肝患者不同感染模式与免疫球蛋白(Ig G、Ig A、Ig M)和补体(C3、C4)的关系。方法采用ELISA技术检测深圳市315例乙肝患者的病毒标志物,按检测结果大三阳、小三阳、小二阳以及乙肝病毒外膜大蛋白结果进行分组。对乙肝患者不同感染模式分别同时进行免疫球蛋白和补体检测,分析乙肝患者的不同感染模式与免疫状况的相关性。结果大三阳与对照组相比,Ig A、Ig G和Ig M增高(U=14.05,9.31,9.15,P<0.01),且C3和C4降低(U=8.22,5.14,P<0.01),差异均有显著统计学意义;小三阳与小二阳之间的比较,3种免疫球蛋白和2种补体的改变(U=1.36,0.34,0.22,0.05,0.06,P>0.05),差异均无统计学意义;小三阳与大三阳之间比较,Ig A、Ig G和Ig M增高(U=5.27,4.35,5.09,P<0.01),C3和C4降低(U=3.68,3.92,P<0.01),差异均具有显著统计学意义;小二阳与大三阳之间比较,Ig A和Ig G增高有统计学意义(U=1.97,2.51,P<0.05)。结论乙肝患者感染模式越严重越容易出现免疫球蛋白的增高而补体的降低。在肝炎的抗病毒治疗中,要治理尽量使HBe Ag转阴,降低对机体免疫系统的损害。

Objective To investigate the relationship between infection patterns of Hepatitis B patients and theconcentrations of immunoglobulin（Ig G,Ig A,Ig M）and complement（C3,C4）. Mehods The viral markers in 315 hepatitis Bcases in Shenzhen city were detected by ELISA. The patients were divided into,accoding to the results,Big- three- Yang（HBs Ag ＋ HBs Ab- Hbe Ag ＋ HBe Ab- HBc Ab ＋） group; Small- three- yang（HBs Ag ＋ HBs Ab- Hbe Ag- HBe Ab ＋ HBc Ab ＋）group; Small-two-yang（HBs Ag＋ HBs Ab- Hbe Ag- HBe Ab-HBc Ab＋） group and hepatitis B virus large protein groups. Therelationship between the concentrations of immunoglobulins and complements and different infection patterns of hepatitis Bcases were also analyzed.Results The concentrations of Ig A,Ig G and Ig M in cases of big-three-yang group were increasedcompared with that of control group,whereas that of complement C3 and C4 were decreased,exhibiting significant differences（U=8.22,5.14,P〈0.01）. The changes of concentrations of Ig A, Ig G and Ig M, and complements showed no significant differencesin cases of small-three-yang group compared with small-two-yang（U=1.36,0.34,0.22,0.05,0.06,P〉0.05）; the levels of Ig A,Ig G and Ig M elevated both in small-three-yang group and big-three-yang group（U=5.27,4.35,5.09, P〈0.01）, while that of C3 and C4 both significantly decreased（U=3.68,3.92,P〈0.01）. The levels of Ig A and Ig G in cases of small- two- yang grouprevealed some significant difference compared with that of big-three-yang group（（U=1.97,2.51,P〈0.05）. Conclusion Thelevels of immunoglobulins would elevate and the levels of complements would drop in hepatitis B cases with severe infectionpatterns..Thus negative conversion of HBe Ag is indicated as early as possible during antiviral treatment of hepatitis B cases toreduce the injury to the immune system and achieve high therapeutic effect.