丙型肝炎病毒感染者17种自身抗体的检测及其临床意义

目的：观察丙型肝炎病毒（HCV）感染者的自身抗体情况，了解 HCV 感染后疾病严重程度与抗核抗体（ANA）谱阳性率的关系。方法收集123例 HCV感染患者的血清标本作为 HCV组，根据病毒感染的严重程度将其分为3组：A组，急性丙型肝炎17例；B组，慢性丙型肝炎64例；C组，肝硬化42例。将排除病毒感染和自身免疫性疾病的健康者52例作为对照组。采用间接酶联免疫吸附测定法检测抗 HCV 抗体，线性免疫印迹法检测123例 HCV 感染者血清中抗 dsDNA、核小体、组蛋白、SmD1、增殖细胞核抗原（PCNA）、P0、SSA/Ro60kD、SSA/Ro52kD、SSB/La、CENP-B、Scl70、U1-snRNP、AMA-M2、Jo-1、PM-Scl、Mi-2和Ku 抗体。结果47．2％（58/123）HCV 感染者至少1种自身抗体阳性，明显高于对照组的9．6％，差异有统计学意义（P＜0．01）。ANA谱17种自身抗体阳性率由高到低依次为：抗SSA/Ro52kD抗体（23．6％）、抗SSB/La抗体（6．5％）、抗 Mi-2抗体（5．7％）、抗PCNA抗体（4．9％）、抗核小体抗体（3．3％）、抗 Ku 抗体（3．3％），抗 dsDNA、SmD1、AMA-M2、PM-Scl 抗体均为1．6％，抗组蛋白、P0、SSA/Ro60kD、CENP-B、U1-snRNP、Jo-1抗体均为0．8％，未发现抗Scl-70抗体。ANA谱阳性率与 HCV感染者的性别和年龄无关（P＞0．05）。急性丙型肝炎患者、慢性丙型肝炎患者与肝硬化患者的 ANA 谱阳性率分别为47．1％、40．6％和57．1％，差异无统计学意义（P＝0．25）。结论 HCV感染者可检测到多种自身免疫性疾病的特异度抗体，其ANA谱阳性率与性别、年龄及 HCV感染疾病的严重程度均无关。

17 kinds of auto-antibodies in patients with hepatitis C virus infection

Objective To assess the prevalence of auto-antibodies in patients with HCV infection and observe the significance of ANA profile prevalence in HCV infected severity. Methods Indirect enzyme-linked Immunosorbent assay （ELISA） was used to de- tect anti-HCV antibody. Line immunoassay （IAA） was used to detect 17 auto-antibodies in 123 patients with HCV infection. Results 58 of 123 patients with HCV infection had one autoantibody at least,whose prevalence （47.2%） was statistically higher tban control group （9.6 % ）. The prevalence of t7 kinds of auto-antibodies in patients respectively showed 29 （23.6 %） of HCV infected patients had anti-SSA/Ro52kD. 8 （6.5%） had anti-SSB/La. 7 （5.7%） had anti-Mi-2. 6 （4.9%） had anti-PCNA. 4（3.3%） bad an- ti-Nucleosome and anti-Ku. 2 （1.6 % ） had anti-dsDNA, anti-StuD1, anti-AMA-M2, anti-PM-Scl. 1 （0.8 % ） had anti-CENP-B, anti- SSA/Ro60kD,anti-U1 snRNP,anti-Jo 1, none had anti-Sel 70. The presence of antibodies in ANA profile were not associated with subjec（s gender or age（P）0.05）, the prevalence of ANA profile in patients with acute hepatitis C, chronic hepatitis C, cirrhosis were ,17.1 % ,40.6 % and 57.1 % respectively, showing no significant differences. Conclusion Several specific antibodies in autoim- reunify diseases are at present in patients with HCV infection. The prevalence of ANA profile has no correlation with sex,and age, and liver disease severity.