免疫球蛋白水平对乙肝患者的临床意义

Clinical significance of serum immunoglobulin levels for hepatitis B patients

目的探讨免疫球蛋白水平对乙肝患者的临床意义。方法随机选取2013年8月-2015年8月本院确诊为乙型肝炎的患者,依诊断标准分为3组试验组:急性乙肝组88例,慢性乙肝组95例,慢性重型乙肝组90例,同期健康体检者92例作为对照组,比浊法检测血清免疫球蛋白IgG、IgA、IgM水平,比较分析各组结果。结果急性乙肝组IgG、IgA水平较对照组显著升高,差异有统计学意义(P<0.05);慢性乙肝组与慢性重型乙肝组的IgG、IgA、IgM水平均较对照组显著升高,差异有统计学意义(P<0.05)。慢性重型乙肝组的IgG、IgA、IgM水平较急性乙肝组与慢性乙肝组显著升高,差异有统计学意义(P<0.05)。经治疗后,恶化组患者的IgG、IgA、IgM及TBIL水平较改善组显著升高,差异有统计学意义(P<0.05);恶化组患者的PTA水平较改善组显著降低,差异有统计学意义(P<0.05)。结论免疫球蛋白水平的监测对乙肝患者的诊断、疗效评估、判断预后等有重要意义。

Objective To explore the clinical significance of serum immunoglobulin levels for hepatitis B patients. Methods Confirmed hepatitis B patients accepted in our hospital from August 2013 to August 2015 were randomly selected and divided into three test groups according to diagnostic standard： the acute hepatitis B group with 88 cases, the chronic hepatitis B group with 95 cases, and the severe hepatitis B with 90 cases. 92 cases of normal healthy in the same period were randomly selected as the control group. Serum immunoglobulin levels of IgG, IgA, IgM were determined by immunonephelometry, and the results of each group were compared and analyzed. Results The serum levels of IgG and IgA in acute hepatitis B. was significantly higher than that of the control group, with the differences statistically significant（P 〈 0.05） ; the serum levels of IgG, IgA and IgM in chronic and severe hepatitis B were significantly higher than the control group, with the differences statistically significant （ P 〈 0.05 ）. The serum levels of IgG, IgA and IgM in severe hepatitis B were significantly higher than acute and chronic hepatitis B, with the differences statistically significant （ P 〈 0.05）. After medical treatment, the serum levels of IgG, IgA, IgM and TBIL in deteriorate group was significantly higher than improvement group, with the differences statistically significant （ P 〈 0.05） ; the levels of PTA in deteriorate group was significantly lower than improvement group, with the differences statistically significant （P 〈 0.05）. Conclusion The monitoring of serum immunoglobulin levels is helpful to diagnosis, efficacy assess and prognosis for hepatitis B patients.