血清免疫学指标检测在乙肝诊治中的应用价值

Application value of detection of serum immunological indexes in diagnosis and treatment of hepatitis B

目的探讨血清免疫学指标检测在乙肝诊治中的应用价值。方法选取2019年1月至2021年12月聊城市人民医院收治的180例乙肝患者作为观察组,并选取本院同期180名健康体检者作为对照组。所有研究对象均行血清免疫学指标(IgG、IgA、IgM)、血清乙肝标志物[乙肝表面抗原(HBsAg)、乙肝表面抗体(抗-HBs)、乙肝e抗原(HBeAg)、乙肝e抗体(抗-HBe)、乙肝核心抗体(抗-HBc)]检测,并进行乙型肝炎病毒(HBV)-DNA定量分析。比较两组免疫学指标水平,分析观察组不同病毒载量、血清乙肝标志物及是否伴有肝衰竭患者的IgG、IgA、IgM水平。结果观察组IgG、IgA、IgM水平均高于对照组,差异有统计学意义(P<0.05)。观察组HBV-DNA>5.0×10^(2)copies/ml患者IgG、IgA、IgM水平均高于HBV-DNA≤5.0×10^(2)copies/ml患者,差异有统计学意义(P<0.05)。观察组HBsAg(+)HBeAg(+)抗-HBc(+)患者IgG、IgA、IgM水平均高于HBsAg(+)抗-HBc(+)抗-HBe(+)、抗-HBc(+)HBsAg(+)及其他患者,差异有统计学意义(P<0.05)。观察组合并肝衰竭患者IgG、IgA、IgM水平均高于未合并肝衰竭患者,差异有统计学意义(P<0.05)。IgG、IgA、IgM水平在合并肝衰竭患者早期、中期、晚期中依次升高,差异有统计学意义(P<0.05)。结论血清IgG、IgA、IgM指标对乙肝疾病的诊断及严重程度的评估具重要作用,可作为重要的检测指标。

Objective To investigate the application value of detection of serum immunological indexes in the diagnosis and treatment of hepati-tis B.Methods 180 patients with hepatitis B admitted to Liaocheng People's Hospital from January 2019 to December 2021 were selected as the ob-servation group,and 180 healthy subjects were selected as the control group during the same period.Serum immunological indexes(IgG,IgA,IgM),serum hepatitis B markers(hepatitis B surface antigen[HBsAg],hepatitis B surface antibody[anti-HBs],hepatitis Be antigen[HBeAg],hepatitis Be antibody[anti-HBe],hepatitis B core antibody[anti-HBc])were detected,and hepatitis B virus(HBV)-DNA was quantitatively analyzed.The levels of immunological indexes between the two groups were compared,and the IgG,IgA and IgM levels of different viral loads,serum markers of hepati-tis B and patients with or without liver failure were analyzed in the observation group.Results The levels of IgG,IgA and IgM in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).The levels of IgG,IgA and IgM in patients with HBV-DNA>5.0×10^(2) copies/ml in the observation group were higher than those in patients with HBV-DNA≤5.0×10^(2) copies/ml,the differences were statistically significant(P<0.05).The levels of IgG,IgA,and IgM in HBsAg(+)HBeAg(+)anti-HBc(+)patients in the observation group were higher than those in HBsAg(+)anti-HBc(+)anti-HBe(+),anti-HBc(+)HBsAg(+)and other patients,the differences were statistically signifi-cant(P<0.05).The levels of IgG,IgA and IgM in patients with liver failure were higher than those in patients without liver failure,and the differenc-es were statistically significant(P<0.05).The levels of IgG,IgA and IgM were increased successively in the early,middle and late stages of patients with liver failure,and the differences were statistically significant(P<0.05).Conclusion Serum IgG,IgA and IgM markers play an important role in the diagnosis and evaluation of the severity of hepatitis B disease,and can be used as important detection indicators.