感染丙型肝炎病毒患者血清自身抗体检测的临床意义

Clinical Significance of Serum Autoantibody Detection in Patients Infected with Hepatitis C Virus

目的研究感染丙型肝炎病毒(HCV)患者血清自身抗体检测的临床价值。方法分别选取2018年1~12月收治的90例HCV感染患者(观察组)和42名健康体检者(对照组),经酶联免疫吸附方法检测血清内抗核抗体(ANA)、抗平滑肌抗体(SMA),经散色比浊法检测抗线粒体抗体M2型(AMA-M2),类风湿因子(RF),经印迹法检测抗可溶性肝抗原/抗肝胰抗原抗体(SLA/LP)、抗肝肾微粒体抗体Ⅰ型(LKM-1)、抗肝细胞质抗体Ⅰ型(LC-1)。结果90例HCV感染患者中自身抗体阳性41例,自身抗体阳性率45.56%,高于健康体检组4.76%(2/42),差异有统计学意义(χ^(2)=21.696,P<0.05);丙肝携带者、丙型肝炎、丙肝肝硬化的自身抗体阳性率分别为43.33%(13/30)、40.00%(12/30)、53.33%(16/30),组间对比差异无统计学意义(P>0.05);自身抗体ANA、ASMA、AMA-M2、RF的阳性率分别为32.22%(29/90)、8.89%(8/90)、11.11%(10/90)、5.56%(5/90);ANA滴度主要为1∶100,包含胞质型、颗粒型等荧光类型。两组的ALT、AST自身抗体阳性组与阴性组的γ-GT与TBIL对比,差异有统计学意义(P<0.05)。结论HCV感染者体内抗体类型非常多,影响肝功能,使其发生损伤。在临床上,应对该疾病加强重视,为后续同类研究及临床治疗提供参考依据。

Objective To study the clinical value of serum autoantibodies in patients infected with hepatitis C virus(HCV).Methods From January 2018 to December 2018,90 patients with HCV infection(observation group)and 42 healthy subjects(control group)were selected to detect anti nuclear antibody(ANA),anti smooth muscle antibody(SMA),anti mitochondrial antibody M2(AMA-M2)by enzyme-linked immunosorbent assay,and rheumatoid factor(RF)by dispersive turbidimetry,Anti soluble liver antigen/anti hepatopancreatic antigen antibody(SLA/LP),anti liver and kidney microsomal antibody type I(LKM-1)and anti hepatocyte plasma antibody type I(LC-1)were detected by Western blot.Results Forty-one of the 90 patients with HCV infection were positive for autoantibodies,and the positive rate of autoantibodies was 45.56%,which was higher than 4.76%(2/42)in the physical examination group(χ^(2)=21.696,P<0.05).The positive rates of autoantibodies in hepatitis C carriers,hepatitis C and liver cirrhosis were 43.33%(13/30),40.00%(12/30)and 53.33%(16/30).There was no significant difference between the groups(P>0.05).The positive rates of ANA,ASMA,AMA-M2 and RF were 32.22%(29/90),8.89%(8/90),11.11%(10/90)and 5.56%(5/90),respectively.ANA titer is mainly 1∶100,including cytoplasmic,granular and other fluorescent types.The difference between ALT and AST autoantibody positive group and negative groupγ-GT and TBIL,there was significant difference between(P<0.05).Conclusion There are many types of antibodies in HCV infected patients,which affect liver function and cause damage.Clinically,we should pay more attention to the disease,so as to provide basis for follow-up similar research and clinical treatment.