血清C3、C4及IgG水平与慢性乙型肝炎肝硬化病情程度相关性分析

An analysis of the relationship between serum C3,C4 and IgG levels and the severity of liver cirrhosis in patients with chronic hepatitis B

目的分析慢性乙型肝炎肝硬化患者的血清C3、C4及IgG水平的变化及其临床意义。方法选取2018年3月至2019年12月期间在南京医科大学附属淮安第一医院治疗的116例慢性乙型肝炎患者为观察组,116例同期体检的健康人为对照组,观察组患者均行肝脏病理学检测,检测血清补体C3、C4以及IgG水平,同时分析观察组所有患者C3、C4及IgG水平与肝组织病理学分级、分期的相关性。结果观察组的补体C3[(0.84±0.12)g/L]、C4[(0.23±0.05)g/L]水平均低于对照组[C3:(1.07±0.21)g/L][C4:(0.31±0.06)g/L],而观察组患者的血清IgG[(27.59±6.27)mg/L]水平高于对照组[(16.81±3.15)mg/L](P<0.05)。观察组中G2~G4级炎症患者的补体C3及C4的水平明显低于G1级患者(F=4.142,P<0.05;F=4.142,P<0.05)。观察组中S2-S4级炎症患者的补体C3及C4的水平明显低于S1级患者(F=8.512,P<0.05)。并且≥G2和G4分级与补体C3、C4呈现出负相关,与IgG呈现出正相关(r=0.572,P=0.014;r=0.589,P=0.009);≥S2和S4分级与补体C3、C4呈现出负相关,与IgG呈现出正相关(r=0.631,P=0.007;r=0.551,P=0.007)。结论血清C3、C4及IgG与慢性乙型肝炎患者的肝硬化病情严重程度呈现一定的相关性,对患者的诊治及预后具有指导意义。

Objective To analyze the changes of serum complement 3(C3),complement 4(C4)and immunoglobin G(IgG)levels in patients with chronic hepatitis B(CHB)and liver cirrhosis and their clinical significance.Methods One hundred and sixteen patients with CHB admitted from March 2018 to December 2019 were selected as the observation group and 116 healthy persons who underwent physical examination at the same period of time were enrolled as the control group.The serum levels of C3,C4 and IgG were detected in both groups of people,and the correlation between the levels of C3,C4 and IgG and the grades and stages of liver histopathology in the observation group were analyzed.Results The levels of C3[(0.84±0.12)g/L]and C4[(0.23±0.05)g/L]of the observation group were lower than those of the control group[C3:(1.07±0.21)g/L][C4:(0.31±0.06)g/L],while the serum IgG[(27.59±6.27)mg/L]level of the observation group was higher than that of the control group[(16.81±3.15)mg/L](P<0.05).The levels of C3 and C4 in patients with G2-G4 grades of inflammation in the observation group were significantly lower than those in patients with grade G1(F=4.142,P<0.05;F=4.142,P<0.05).In the observation group,the levels of complement C3 and C4 in patients with grades of S2-S4 inflammation were significantly lower than those in patients with grade S1(F=8.512,P<0.05).The grades of≥G2 and G4 were negatively correlated with complement C3 and C4,and positively correlated with IgG levels(r=0.572,P=0.014;r=0.589,P=0.009).The grades of≥S2 and S4 were negatively correlated with C3,C4,whereas positive correlated with IgG(r=0.631,P=0.007;r=0.551,P=0.007).Conclusion There is a certain correlation between serum C3,C4 and IgG levels and the severity of liver cirrhosis in CHB patients,which has significance for the diagnosis,treatment and prognostic evaluation of patients with CHB.