慢性丙型肝炎患者抗核抗体谱的表达及临床意义

Expression and clinical significance of LIA-ANAs in patients with chronic hepatitis C

目的分析慢性丙型肝炎患者抗核抗体谱(LIA-ANAs)的表达,探讨慢性丙型肝炎患者出现自身抗体的临床意义。方法采用回顾性研究,选取2018年3—7月海军军医大学附属长海医院感染科门诊和住院收治的慢性丙型肝炎患者81例作为慢性丙型肝炎组,同时选取81例体检健康者作为健康对照组,检测2组LIA-ANAs、丙型肝炎病毒(HCV)-RNA载量及肝功能结果并进行统计学分析。结果81例慢性丙型肝炎患者共37例检出LIA-ANAs,阳性率为45.67%,阳性率显著高于健康对照组的4.93%(4/81),差异有统计学意义(χ^2=33.300,P<0.001)。30例(37.04%)患者检出1种特异性自身抗体,占LIA-ANAs阳性者的81.08%;6例(7.40%)检出2种特异性自身抗体,占LIA-ANAs阳性者的16.21%;1例(1.23%)检出3种特异性自身抗体,占LIA-ANAs阳性者的2.70%。81例慢性丙型肝炎患者中,ANA滴度≥1∶100共6例;24例HCV-RNA≥1×103 copies/mL。LIA-ANAs阳性和阴性组间HCV-RNA载量水平差异有统计学意义(χ^2=4.645,P<0.05),2组丙氨酸氨基转移酶(ALT)和天门冬氨酸氨基转移酶(AST)的中位数差异有统计学意义,LIA-ANAs阳性组ALT和AST水平均高于阴性组(U=595.000、597.500,P=0.0382、0.0403)。81例慢性丙型肝炎患者LIA-ANAs阳性和阴性组间年龄(t=0.720,P=0.479)、性别(χ^2=0.400,P=0.520)差异无统计学意义。结论慢性丙型肝炎患者容易产生自身抗体,自身抗体的产生与性别、年龄无关,但与肝功能(ALT、AST)、HCV-RNA载量有关。对慢性丙型肝炎患者血清进行LIA-ANAs的检测,将有助于临床诊治的需求。

Objective To analyze the expression of anti nuclear antibody spectrum(LIA-ANAs)in patients with chronic hepatitis C and to explore the clinical significance of autoantibodies in patients with chronic hepatitis C.Methods In the retrospective study,81 patients with chronic hepatitis C were selected from the outpatients and inpatients in the Department of Infectious Diseases of Changhai Hospital of Naval Military Medical University from March to July 2018 as the chronic hepatitis C group,and 81 cases from physical examination healthy people were selected as the healthy control group,and the results of LIA-ANAs,hepatitis C virus(HCV)-RNA load and liver function were measured and analyzed statistically.Results The positive rate of LIA-ANAs was 45.67%,which was significantly higher than that of the control group(4.93%,4/81),the difference was statistically significant(χ^2=33.300,P<0.001).One specific autoantibody was detected in 30 cases(37.04%),which accounted for 81.08%of the patients with positive LIA-ANAs;two specific autoantibodies were detected in 6 cases(7.40%),which accounted for 16.21%of the patients with positive LIA-ANAs;three specific autoantibodies were detected in 1 case(1.23%),which accounted for 2.70%of the patients with positive LIA-ANAs.Among 81 patients with chronic hepatitis C,6 patients had ana titer≥1∶100,24 patients had HCV-RNA≥1×103 copies/mL.There was a significant difference in HCV-RNA load between the positive and negative groups(χ^2=4.645,P<0.05).The median difference in ALT and AST between the two groups was statistically significant,the levels of ALT and AST in the positive group were higher than those in the negative group(U=595.000,597.500,P=0.0382,0.0403).There was no significant difference in age(t=0.720,P=0.479)and gender(χ^2=0.400,P=0.520)between the positive and negative groups of LIA-ANAs in 81 patients with chronic hepatitis C.Conclusion Patients with chronic hepatitis C are prone to produce autoantibodies.The production of autoantibodies is not related to gender and age,but related to liver function(ALT,AST)and HCV-RNA load.The detection of LIA-ANAs in sera of patients with chronic hepatitis C will be helpful for clinical diagnosis and treatment.