肝硬化脾与乙肝病毒复制指标血中表达水平的关系探讨

Clinical research of the relationship between spleen and quantity of HBeAg in serum of hepatitis cirrhosis.

了解脾脏对乙肝病毒复制指标HCeAg在血中表达水平的影响。术前HBVDNA的表达采用PCR法进行常规检测 ;HBeAg的定量检测采用微量酶免分析法 (MEIA) ;血标本分别来自 5 0例术中取的脾动、静脉血 ,以及在术前一周、术后一周及术后一年抽取的外周血 ,2 0例非手术患者血作为对照。在HBVDNA表达为阳性组的患者中 ,研究组术前与对照组间血中HBeAg的定量检测比无统计学差异 ;脾动脉血中HBeAg的定量检测 ,无统计学差异 ;术后一周及术后一年HBeAg的定量值与术前及对照组比有统计学差异P <0 0 1;在HBVDNA表达为阴性组的患者中 ,脾动、静脉血及手术前后外周血中的HBeAg的定量检测 ,均无统计学差异。当乙肝肝硬化患者血中HBVDNA阳性时 ,脾脏对HBeAg的表达具有免疫调节作用 ,即抑制乙肝病毒的复制 ;当HBVDNA阴性时 ,无此调控作用。乙肝肝硬化脾脏免疫调节作用的两面性有待于进一步研究。

To understand if spleen had some influence on quantitative expression of HBeAg in the serum of hepatitis cirrhosis. Expression of HBVDNA had been examinated by the polymerase chain reaction (PCR). The quantity of HBeAg had been inspected by microenzyme immunoassay (MEIA), blood come from spleenarteria and vein of 50cases patients during the operation, and the exrernal blood before and after the operation and one year after the operation, respectively, and 20cases no-operation patients's external blood as control group. There is no stastic signification between before operation patients's and control group's patients external blood expression of HBeAg in HBVDNA positive. But the quantitative expression of HBeAg in the group after operation one week or one year is higher than that of before the operation's and that of control group's, there is stastic signification P<0.001). There is no stastic signification between before or after operation patients's and control group's external blood expression of HBeAg in HBVDNA negative. The quantitative expression of HBeAg of spleen arterial and vein has no stastic signification both in HBVDNA positive and HBVDNA negative patients; there is no signification between before and after operation patient's external blood if whose expression of HBVDNA was negative. The spleen has an effect on HBeAg expression in the blood of the patients, whose expression of HBVDNA is positive, in contrary, it has no immunity regulate function. The mechanism need further investigation.