成都某院乙型肝炎患者的免疫特点分析

目的分析成都某院乙型肝炎患者的免疫特点。 方法将329例乙型肝炎患者分为急性乙型肝炎组、慢性乙型肝炎组、乙型肝炎肝硬化组及乙型慢加急性肝功能衰竭组,比较各组患者的免疫球蛋白、补体和T淋巴细胞亚群等免疫指标的差异。 结果急性乙型肝炎组与慢性乙型肝炎组相比,各项免疫指标差异均无统计学意义（P均> 0.05）。乙型肝炎肝硬化组患者的IgG、IgA和IgM水平分别为（18.12 ± 5.70）g/L、（3.63 ± 0.94）g/L和（4.39 ± 0.82）g/L,显著高于其余3组;而该组患者CD3⁺ T、CD4⁺ T和CD8⁺ T细胞计数分别为（583.10 ± 276.35）个/μl、（339.13 ± 131.55）个/μl和（205.23 ± 41.22）个/μl,显著低于其余3组（P均< 0.05）。乙型慢加急性肝功能衰竭组患者的补体C3和C4水平分别是（0.39 ± 0.27）g/L和（0.08 ± 0.07）g/L,显著低于其余3组（P均< 0.05）。随着肝功能损害程度的加重,慢性乙型肝炎患者的ALT、AST、TBil和IgG水平均逐渐升高,而补体C3、C4、CD3⁺ T和CD4⁺ T细胞计数则逐渐下降（P均< 0.05）。 结论乙型肝炎患者的免疫状态与疾病进展及病情严重程度有一定相关性,肝硬化及肝功能衰竭患者体内存在免疫球蛋白升高、补体下降及T细胞损耗等免疫紊乱的情况。

Study on the immune states of patients infected with hepatitis B virus in a hospital in Chengdu

ObjectiveTo investigate the immune states of patients with hepatitis B virus (HBV) infection. MethodsTotal of 329 patients infected with HBV infection were divided into acute hepatitis B (AHB) group, chronic hepatitis B (CHB) group, cirrhosis group and acute-on-chronic liver failure (ACLF) group. The immune indexes such as immunoglobulin (Ig), complement (C) and T-lymphocyte subsets of groups above-mentioned were tested and analyzed, respectively. ResultsThe immune indexes had non-significant differences between AHB group and CHB group (P all > 0.05). Patients in cirrhosis group had significantly higher levels of IgG, IgA and IgG, which were (18.12 ± 5.70) g/L, (3.63 ± 0.94) g/L and (4.39 ± 0.82) g/L, respectively; but had significantly lower levels of CD3⁺ T, CD4⁺ T and CD8⁺ T cell counts (P all < 0.05), which were (583.10 ± 276.35) cells/μl, (339.13 ± 131.55) cells/μl and (205.23 ± 41.22) cells/μl. While, the levels of C3 and C4 were (0.39 ± 0.27) g/L and (0.08 ± 0.07) g/L in ACLF group, respectively, which were significantly lower than those in other groups. As liver damages progressed, the levels of ALT, AST, TBil and IgG all gradually increased, while the levels of C3 and C4 and the counts of CD3⁺ T, CD4⁺ T cell gradually declined. ConclusionsThe immune states of patients with hepatitis B have a certain relationship with disease progression or severity. The patients with cirrhosis and liver failure have autoimmune disorders, including high-level immunoglobulin, low-level complement and T cell loss.