• 玉田縣醫(yī)院感染疾病科（河北玉田，064100）;

【摘要】　目的　 探討慢性丙型肝炎患者干擾素治療前后血清自身抗體的合并狀況。　方法　 回顧性分析2005年2月-2008年2月66例慢性丙型肝炎患者應用干擾素治療前后的檢測結(jié)果，觀察治療前后自身抗體合并狀況及與干擾素療效的關系。　結(jié)果　 ①66例慢性丙型肝炎患者中39例自身抗體陽性，陽性率59.1%（39/66），主要為ANA；②自身抗體的產(chǎn)生與年齡相關，而與性別、HCVRNA定量無關；③自身抗體陽性組干擾素應答率66.7% （26/39）明顯高于陰性組40.7%（11/27），二者比較差異有統(tǒng)計學意義；④干擾素治療后，自身抗體陰性組自身抗體檢出率為44.4%（12/27），但滴度均 lt;1∶320；治療前抗甲狀腺球蛋白抗體陽性患者會出現(xiàn)較高的甲狀腺功能異常率。　結(jié)論　 慢性丙型肝炎合并血清自身抗體陽性的患者干擾素應答率高于陰性組，但應注意抗甲狀腺球蛋白抗體，以預測不良反應。
【Abstract】　Objective　 To explore the consolidation of serum autoantibodies in chronic hepatitis C patients treated with interferon.　Methods　 The clinical data of 66 patients with chronic hepatitis C treated with interferon from February 2005 to February 2008 were retrospectively analyzed. The relationship between the consolidation of serum autoantibodies and the effect of interferon was observed.　Results　 ①There were 39 patients with positive autoantibodies; the positive rate was 59.1% (39/66) and ANA was the main antibody. ②The appearance of autoantibodies correlated with the patients′ ages but not with the sexes and CVRNA quantification. ③The interferon response rate in autoantibodies positive group was 66.7% (26/39) which was much higher than that in the negative group; the difference between the two groups was significant. ④After the interferon treatment, the autoantibody detection rate in autoantibody negative group was 44.4%(12/27)and the titer was lower than 1:320; before the treatment, the anti-thyroglobulin antibody-positive patients had a higher rate of thyroid dysfunction.　Conclusion　 The interferon response rate in chronic hepatitis C patients with positive serum autoantibodies is higher than that in the patients with negative serum autoantibodies. Anti-thyroglobulin antibodies should be noted to predict the adverse effects.

引用本文： 李新華,侯寶國. 慢性丙型肝炎患者干擾素治療前后血清自身抗體變化的臨床觀察. 華西醫(yī)學, 2010, 25(11): 2022-2024. doi: 復制

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  1. 1. 　王江濱. 合并自身免疫現(xiàn)象的丙型肝炎與自身免疫性肝炎的鑒別及干擾素治療誘導的自身免疫現(xiàn)象[J]. 中國實用內(nèi)科雜志, 2006, 26(23): 1855-1857.
  2. 2. 　Longman RS, Talal AH, JacobsonI M, et al. Presence of functional Dendritic cells in patients chronically infected with hepatitis C virus [J]. Blood, 2004, 103(3): 1026-1029.
  3. 3. 　王九平, 李軍, 白雪帆. T細胞應答在丙型肝炎病毒持續(xù)感染中的作用[J]. 國際流行病學傳染病學雜志, 2007, 34(1): 66-67.
  4. 4. 　Vella FS, Orlando P, Attanasi F, et al. Autoantibodies in chronic hepatitis C markers of autoimmunity or non specificevents[J]. Recent Prog Med, 2001, 92(2): 107-112.
  5. 5. 　Darling JM, Wright TL. Immune responses in hepatitis C: is virus or host the problem? [J]. Curr Opin Infect Dis, 2004, 17(3): 193-198.