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单采血浆后自身抗体阳性慢性丙型肝炎患者肝组织的病理学特点
Pathological features of liver tissue in autoantibody-positive chronic hepatitis C patients after plasmaphoresis
文章发布日期:2018年01月05日  来源:  作者:伍慧丽,郑素军,王泰龄,等  点击次数:669次  下载次数:115次

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【摘要】:目的观察单采血浆后慢性丙型肝炎(CHC)患者自身抗体的检出率及其特点,了解自身抗体阳性CHC患者肝组织病理学特点。方法收集1992年1月-1995年12月甘肃省定西县医院和定西传染病专科医院的120例单采血浆后感染HCV的患者为试验组,另外选取同地区健康人群11例作为对照组。对CHC患者进行自身抗体检测;将自身抗体阳性组(n=44)与阴性组(n=76)肝组织病理学特点进行对比分析。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验。结果120例单采血浆后CHC患者自身抗体检出率为36.7%(44/120),主要的自身抗体为抗核抗体,占21.7%。自身抗体阳性组较阴性组肝小叶内点灶状坏死炎症评分(2.11±0.88 vs 1.64±0.88,t=2.349,P=0.021)及汇管区内部细胆管反应评分(1.86±0.71 vs 1.13±0.66,t=4.217,P<0.001)明显升高;自身抗体阳性组肝小叶间胆管损伤比例较阴性组升高,差异有统计学意义(86.4% vs 55.3%,χ2=12.129,P=0.001);而2组肝纤维化和肝脂肪变性程度差异无统计学意义(P值均>0.05)。结论单采血浆后CHC患者常见自身抗体阳性,自身抗体阳性者部分肝脏病理损伤较重。
【Abstract】:ObjectiveTo investigate the detection rate and features of autoantibodies in chronic hepatitis C (CHC) patients after plasmaphoresis, as well as the liver pathological features of autoantibody-positive CHC patients. MethodsA total of 120 patients who were infected with hepatitis C virus after plasmaphoresis in the Hospital of Dingxi County and Dingxi Hospital of Infectious Diseases from January 1992 to December 1995 were selected as test group; 11 healthy people from the same region were selected as control group. Autoantibody detection was performed for the 120 CHC patients, and liver pathological features were compared between the autoantibody-positive group(n=44) and autoantibody-negative group(n=76) of these patients. The t test was used for comparison of continuous data, and the chi-square test was used for comparison of categorical data. ResultsOf all 120 CHC patients who underwent plasmaphoresis, 44 (36.7%) were found to have serum autoantibodies, with antinuclear antibodies as the most common type (21.7%). Compared with the autoantibody-negative group, the autoantibody-positive group had significantly higher scores of focal necrosis inside the hepatic lobules (211±0.88 vs 164±0.88, t=2.349,P=0.021) and ductular reaction inside the portal area (1.86±0.71 vs 1.13±0.66, t=4.217,P<0.001), as well as a significantly higher rate of interlobular bile duct injury (86.4% vs 55.3%, χ2=12.129,P=0.001). There were no significant differences between the two groups in the degree of liver fibrosis and hepatic steatosis (both P>0.05). ConclusionAutoantibody-positive are common in CHC patients after plasmaphoresis, and autoantibody-positive patients tend to have more severe injuries of the liver.
【关键字】:血浆; 肝炎, 丙型, 慢性; 自身抗体; 病理状态, 体征和症状
【Key words】:plasma; hepatitis C, chronic; autoantibodies; pathological conditions, signs and symptoms
【引证本文】:WU HL, ZHENG SJ, WANG TL, et al. Pathological features of liver tissue in autoantibody-positive chronic hepatitis C patients after plasmaphoresis[J]. J Clin Hepatol, 2018, 34(2): 281-286. (in Chinese)
伍慧丽, 郑素军, 王泰龄, 等. 单采血浆后自身抗体阳性慢性丙型肝炎患者肝组织的病理学特点[J]. 临床肝胆病杂志, 2018, 34(2): 281-286.

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