CAJ | 학술논문

目的：旨在探讨深圳市乙肝患者 HBV-DNA 与免疫球蛋白（IgA，IgG，IgM）和补体（C3，C4）的关系。方法首先采用实时荧光定量 PCR 技术检测210例乙肝患者的 HBV-DNA，按检测结果10n copies／ml 进行分组，可分为102～108 copies／ml 7组实验组。然后对7组实验组和对照组同时进行 IgA，IgG，IgM 及 C3，C4检测，分析乙肝患者 HBV-DNA 与IgA，IgG，IgM 及 C3，C4的相关性。结果乙肝患者 HBV-DNA 为105～108 copies／ml 时，均出现了 IgA，IgG，IgM 的增高（U ＝12.43，10.96，6.42，P ＜0.01）及 C3，C4的降低（U ＝8.37，6.0，P ＜0.01），而在102～104 copies／ml 只出现 IgA 和 IgM的增高（U ＝2.36，2.04，P ＜0.05），其他指标差异均无统计学意义。在7组实验组的两两比较中，只有104组与105组出现了显著性的变化（IgA，IgM 增高，C4降低；U ＝2.39，2.46，2.09，P ＜0.05，IgG 增高，U ＝3.25，P ＜0.01），而其他低载毒量组之间和高载毒量组之间均无显著性差异。结论乙肝患者体内不同的 HBV 载量会引起 IgA，IgG，IgM 及 C3，C4相应的改变，特别是当 HBV 载量为105～108 copies／ml 的4个实验组，伴随着 HBV-DNA 的增高均出现 IgA，IgG，IgM 增高及C3，C4降低，严重的影响了机体免疫功能，两者呈正相关（r ＝0.967，P ＜0.01）。104组与105组各指标出现显著性改变，提示对乙肝患者的抗病毒护肝治疗中，要尽量将 HBV 载量控制在104 copies／ml 以下，才能达到最小程度损伤免疫功能的疗效。
목적：지재탐토심수시을간환자 HBV-DNA 여면역구단백（IgA，IgG，IgM）화보체（C3，C4）적관계。방법수선채용실시형광정량 PCR 기술검측210례을간환자적 HBV-DNA，안검측결과10n copies／ml 진행분조，가분위102～108 copies／ml 7조실험조。연후대7조실험조화대조조동시진행 IgA，IgG，IgM 급 C3，C4검측，분석을간환자 HBV-DNA 여IgA，IgG，IgM 급 C3，C4적상관성。결과을간환자 HBV-DNA 위105～108 copies／ml 시，균출현료 IgA，IgG，IgM 적증고（U ＝12.43，10.96，6.42，P ＜0.01）급 C3，C4적강저（U ＝8.37，6.0，P ＜0.01），이재102～104 copies／ml 지출현 IgA 화 IgM적증고（U ＝2.36，2.04，P ＜0.05），기타지표차이균무통계학의의。재7조실험조적량량비교중，지유104조여105조출현료현저성적변화（IgA，IgM 증고，C4강저；U ＝2.39，2.46，2.09，P ＜0.05，IgG 증고，U ＝3.25，P ＜0.01），이기타저재독량조지간화고재독량조지간균무현저성차이。결론을간환자체내불동적 HBV 재량회인기 IgA，IgG，IgM 급 C3，C4상응적개변，특별시당 HBV 재량위105～108 copies／ml 적4개실험조，반수착 HBV-DNA 적증고균출현 IgA，IgG，IgM 증고급C3，C4강저，엄중적영향료궤체면역공능，량자정정상관（r ＝0.967，P ＜0.01）。104조여105조각지표출현현저성개변，제시대을간환자적항병독호간치료중，요진량장 HBV 재량공제재104 copies／ml 이하，재능체도최소정도손상면역공능적료효。
Objective To investigate the relationship between Hepatitis B patients with different viral loads and immunoglob-ulin A,G,M and complement C3,C4.Methods Firstly,followed by real-time fluorescence quantitative PCR detection 210 cases of hepatitis B patients with HBV-DNA levels,according to 10n copies/ml different viral load detection results,it was divided into 102 ~108 copies/ml of the experimental groups.Then the experimental groups and control group were simulta-neously detected in immunoglobulin A,G,M and complement C3,C4.Analysed the correlation between HBV loads and im-munoglobulin A,G,M and complement C3,C4.Results When the viral loads of hepatitis B patients were 105 ~108 copies/ml,the testing results of IgA,IgG and IgM were both increasing (U =12.43,10.96,6.42,P <0.01),while C3 and C4 were both decreasing (U =8.37,6.0,P <0.01).When the viral loads of hepatitis B patients were 102 ~ 104 copies/ml,only IgA and IgM were increasing (U =2.36,2.04,P <0.05),the other testing results had no statistical significance.Between the test of 7 experimental groups compared with each other,only 104 group and 105 group had significantly changed (IgA and IgM were increasing,C4 was decreasing,U =2.39,2.46,2.09,P <0.05,IgG was increasing,U = 3.25,P <0.01),but between other low viral loads or high viral loads were not significantly differences.Conclusion The different viral loads of hepatitis B patients could cause the different changes of immunoglobulin A,G,M and complement C3,C4,especially in the 4 groups from 105 to 108 copies/ml.Followed by increasing in viral loads,there were immunoglobulin A,G,M increasing and comple-ment C3,C4 decreasing,and also serious impaction on the immune function of organism.There was a positive correlation be-tween viral loads in vivo and immune damages,correlation coefficient (γ =0.967,P <0.01).When the viral loads from 104 to 105 copies/ml,the testing results had changed significantly.It suggest that should control viral loads under 104 copies/ml in the hepatitis B antiviral treatment,so the effect of immune function damage will be the minimum.