CAJ | 학술논문

目的探讨慢性乙型肝炎病毒（HBV）感染者血清肝特异性自身抗体的检出率及临床意义。方法采用间接免疫荧光法检测186例慢性HBV感染者血清肝特异性自身抗体，回顾性分析AST、ALT、ALP和GGT等生化指标与自身抗体检出率的相关性。结果在186例慢性HBV感染者中检出自身抗体阳性66例（35.5%）；在60例HBV携带者、74例慢性肝炎和52例肝硬化患者肝特异性抗核抗体（ANA）检出率分别为25.0%、24.3%和21.2%，明显高于30例健康对照人群（6.6%，P＜0.05）；自身抗体阳性者以低滴度为主，主要以抗核抗体（ANA）和类风湿因子（RF）阳性为主，免疫荧光模式以“均质型”和“颗粒型”为主；66例自身抗体阳性的HBV感染者血清ALT、AST、ALP和GGT分别为268.4±213.6u/L、241.5±21.3.0u/L、287.2±175.0u/L和168.9±54.7u/L，均显著高于120例自身抗体阴性者（分别为130.8±29.0u/L、118.2±27.3u/L、142.0±63.5u/L和36.5±17.2 u/L，P<0.01）。结论慢性HBV感染可诱导自身免疫反应而有可能产生多种自身抗体，后者的检出率与肝功能指标显著相关，可能是感染HBV后肝组织损伤的重要因素。
목적탐토만성을형간염병독（HBV）감염자혈청간특이성자신항체적검출솔급림상의의。방법채용간접면역형광법검측186례만성HBV감염자혈청간특이성자신항체，회고성분석AST、ALT、ALP화GGT등생화지표여자신항체검출솔적상관성。결과재186례만성HBV감염자중검출자신항체양성66례（35.5%）；재60례HBV휴대자、74례만성간염화52례간경화환자간특이성항핵항체（ANA）검출솔분별위25.0%、24.3%화21.2%，명현고우30례건강대조인군（6.6%，P＜0.05）；자신항체양성자이저적도위주，주요이항핵항체（ANA）화류풍습인자（RF）양성위주，면역형광모식이“균질형”화“과립형”위주；66례자신항체양성적HBV감염자혈청ALT、AST、ALP화GGT분별위268.4±213.6u/L、241.5±21.3.0u/L、287.2±175.0u/L화168.9±54.7u/L，균현저고우120례자신항체음성자（분별위130.8±29.0u/L、118.2±27.3u/L、142.0±63.5u/L화36.5±17.2 u/L，P<0.01）。결론만성HBV감염가유도자신면역반응이유가능산생다충자신항체，후자적검출솔여간공능지표현저상관，가능시감염HBV후간조직손상적중요인소。
Objective To investigate the prevalence of serum liver specific autoantibodies and its clinical significance in patients with chronic hepatitis B virus (HBV)infection. Methods A total of 186 individuals with HBV infection were recruited in the study. Serum liver specific autoantibodies were detected by indirect im-munofluorescence assay. The relationship between the positive rate of the autoantibodies and the biochemical in-dices including ALT,AST,ALP and γ-glutamyltransferase were analyzed retrospectively. Results The positive rate of autoantibodies in this series was 35.5%;The positive rates of ANA in 60 individuals with HBV carrier,74 pa-tients with chronic hepatitis B(CHB)and 52 with cirrhosis were 25.0%,24.3% and 21.2%,respectively,significantly higher than that in 30 healthy control(6.6%,P<0.05);The main immunofluorescence patterns of the autoantibodies were morphologically homogeneous and granular;The serum ALT,AST,ALP and γ-glutamyltransferase in 66 indi-viduals with autoantibody-positive were 268.4±213.6u/L,241.5±21.3.0u/L,287.2±175.0u/L and 168.9±54.7u/L,re-spectively,all of which significantly higher than those in 120 with autoantibody- negative(130.8±29.0u/L,118.2±27.3u/L,142.0±63.5u/L and 36.5±17.2u/L,respectively,P<0.01). Conclusions Chronic HBV infection might in-duce autoimmune reaction and the autoantibodies are correlated to liver function index,suggesting a pathological effect in hepatic tissue injury after HBV infection.