• 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(yīng)用干擾素治療前后的檢測(cè)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(guān)系。　結(jié)果　 ①66例慢性丙型肝炎患者中39例自身抗體陽(yáng)性，陽(yáng)性率59.1%（39/66），主要為ANA；②自身抗體的產(chǎn)生與年齡相關(guān)，而與性別、HCVRNA定量無(wú)關(guān)；③自身抗體陽(yáng)性組干擾素應(yīng)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(jì)學(xué)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(yáng)性患者會(huì)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(yáng)性的患者干擾素應(yīng)答率高于陰性組，但應(yīng)注意抗甲狀腺球蛋白抗體，以預(yù)測(cè)不良反應(yīng)。
【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(guó). 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(xué), 2010, 25(11): 2022-2024. doi: 復(fù)制

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  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(xì)胞應(yīng)答在丙型肝炎病毒持續(xù)感染中的作用[J]. 國(guó)際流行病學(xué)傳染病學(xué)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.