HBeAg阳性的慢性乙型肝炎病毒感染者红细胞CR1基因点突变与天然免疫粘附功能的变化及意义

目的研究乙型肝炎大三阳免疫耐受与应答组患者红细胞补体受体Ⅰ型分子（CR1）基因点突变与红细胞天然免疫粘附功能（RNIAF）的变化,并探讨其临床意义。方法选择肝脏功能正常、血清HBV DNA大于106拷贝/ml的114例大三阳乙型肝炎患者作为免疫耐受组研究对象,选择肝细胞性黄疸和转氨酶高于正常值2倍以上的110例大三阳乙型肝炎患者为免疫应答组研究对象。采用PCR和HindⅢ酶切技术对红细胞CR1基因有无点突变进行分组,同时检测红细胞天然免疫粘附肿瘤细胞功能。结果免疫应答组大三阳慢性乙型肝炎患者未发生点突变机率明显高于耐受组（P〈0.05）,而免疫应答组的RNIAF却明显低于耐受组（P〈0.01）,并且免疫应答组患者随肝脏功能异常的时间延长下降程度逐渐加重。结论红细胞CR1基因点突变发生率和红细胞天然免疫粘附功能的变化与大三阳慢性乙型肝炎患者病情发展关系密切。

Changes on the spots mutation of complement receptor type 1 and on erythrocytes immune adhesion function in HBeAg positive hepatitis patients

Objective To study the changes of the spots mutation of complement receptor type 1（CR1） on erythrocytes nature immune adhesion function（RNIAF） in HBeAg positive patients.Methods A total of 114 HBeAg positive chronic HBV carriers,with normal hepatic function tests and HBV DNA 106 IU/ml in serum were grouped as immune suppressed.110 cases of hepatogenic jaundice and ALT twice greater than normal level have been divided into groups of immune response.Polymerase chain reaction（PCR） and Hind restriction enzyme digestion have been used to classify genomic density polymorphism of complement receptor type 1（CR1） on erythrocytes.At the same time,the function of red cells nature immune-adhering tumor cell was examined.Results The ratio of CR1 gene without spots mutation in immune responsive groups was obviously higher than that of immune suppressed group（P 0.05）.The RNIAF of immune responsive group was significantly lower than the immune suppressed group（P 0.01）.The RNIAF of immune responsive patients lowered gradually along with the extent of liver damage.Conclusion The CR1 gene spots mutation and RNIAF are related with the development and prognosis of HBeAg positive hepatitis patients with.