免疫球蛋白和自身抗体在乙型肝炎肝硬化发病和进展中的表达及与预后的关系

The Expression of Immunoglobulin and Autoantibody in the Pathogenesis and Progression of Hepatitis B Cirrhosis and their Relationship with Prognosis

目的分析免疫球蛋白和自身抗体在乙肝肝硬化发病和进展中的表达及与预后的关系。方法选取福建省建瓯市立医院在2021年1月至2022年1月期间收治的40例乙肝肝硬化患者(肝硬化组)、同期诊治的乙肝患者40例(乙肝组)及健康体检者40名(对照组),对三组对象的免疫球蛋白和自身抗体进行测定,比较三组差异;并对肝硬化组根据预后结局进行分组,比较两组免疫功能差异。结果肝硬化组IgA、IgG含量最高,其次是乙型肝炎组,差异明显(P<0.05)。肝硬化组自身抗体胞浆颗粒型、着丝点型、核颗粒型、核周型、抗线粒体抗体M2亚型(AMA-M2)、抗Ro-52抗体、抗着丝点抗体(ACA)检测阳性率明显高于乙肝组、对照组(P<0.05)。随访12个月,肝硬化患者出现预后不良12例,预后良好28例,预后不良组IgA、IgG及自身抗体检出阳性均高于良好组(P<0.05)。Spearman相关性分析,IgA、IgG水平与胞浆颗粒型、着丝点型、核颗粒型、核周型、AMA-M2、抗Ro-52抗体、ACA阳性率与肝硬化患者的不良预后呈正相关性。结论当乙肝患者进展至肝硬化后,IgA、IgG水平明显升高,自身抗体阳性检出率增加,并能反映出患者预后结局。

Objective To analyze the expression of immunoglobulin and autoantibody in the pathogenesis and progression of hepatitis B cirrhosis and their relationship with prognosis.Methods 40 patients with hepatitis B cirrhosis admitted to Jianou Municipal Hospital from January 2021 to January 2022(cirrhosis group),40 patients with hepatitis B treated during the same period(hepatitis B group)and 40 healthy physical examination cases(control group)were selected.The immunoglobulin and autoantibody of the three groups were determined,and the differences among the three groups were compared.The liver cirrhosis group was divided according to the prognostic outcome,and the difference of immune function between the two groups was compared.Results The content of IgA and IgG in cirrhosis group was significantly higher than that in hepatitis B group and control group,followed by hepatitis B group(P<0.05).The positive rate of autoantibodies cytoplasmic granular,centromeric,nuclear granular,perinuclear,anti mitochondrial antibody M2 subtype(AMA-M2),anti Ro-52 antibody,and anti centromeric antibody(ACA)in cirrhosis group was significantly higher than that in hepatitis B group and control group(P<0.05).During a follow-up of 12 months,12 patients with liver cirrhosis had poor prognosis and 28 had good prognosis.The positive rates of IgA,IgG,and autoantibodies in the poor prognosis group were higher than those in the good prognosis group(P<0.05).Spearman analysis showed that IgA,IgG,cytoplasmic granular type,centromere type,nuclear granular type,perinuclear type,AMA-M2,anti-Ro-52 antibody,ACA are positively correlated with the adverse prognosis of liver cirrhosis patients.Conclusions When hepatitis B patients progress to cirrhosis,IgA and IgG levels increase significantly,and the positive detection rate of autoantibody increases,and can reflect the prognosis of patients.