The relationship between liver function and immune system and viral replication in patients with viral hepatitis
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摘要: 研究肝功能与病毒性肝炎免疫状态、病毒复制的关系。淋巴细胞亚群用碱性磷酸酶法检测。聚合人血清白蛋白受体(PHSA-R)用固相放射免疫法检测。ALT与CD20呈正相关关系;TBil与CD20呈正相关关系,与CD3/CD20呈负相关关系;AST/ALT与CD8呈负相关关系;TBil/ALT与CD8、CD3呈负相关关系。AST/ALT比值与PHSA-R滴度呈正相关。AST/ALT比值升高提示细胞免疫底下及病毒复制活跃,反之提示细胞免疫增高及病毒复制受抑制;ALT体现着免疫对肝细胞膜的损伤,AST体现了病毒复制对肝细胞的破坏。酶胆比值的增高与细胞免疫的相对降低及体液免疫的过度亢进有关。因此,临床研究中应同时参照ALT、AST的值及它们的相对值。Abstract: The study was to investigate the relationship between liver function and the state of immune and viral replication in patients with viral hepatitis.The subsets of lymphocytes were measured by alkaline phosphatase/anti-alkaling phosphatase assay.Poly human serum albumin receptor (PHSA-R) was measured by RIA.The results showed that ALT was positively correlated with CD20 cells (r=0.35, P<0.05) , TBil was positively correlated with CD20 cells (r=0.29, P<0.05) and negatively with the ratio of CD3/CD20 (r=0.30, P<0.05) , AST/ALT was negatively correlated with CD8 cells (r=0.32, P<0.05) , and TBil/ALT was negatively correlated with CD3 cells (r=-0.51, P<0.01) and CD8 cells (r=-0.36, P<0.05) .The ratios of AST/ALT were positively correlated with the titers of PHSA-R (r=-0.45, n=45, P<0.01) .Increasing ratio of AST/ALT indicated low cellular immune and active viral replication.On the contrary, it indicated increasing cellular immune and suppressive viral replication.ALT reflected the injury of liver cell membrane caused by humoral immune.AST reflected the injury of liver cells caused by viral replication.Increasing ration of TBil/ALT indicated hyperfunction of humoral immune and lower cellular immune relatively.So we must use simultaneously ALT, AST and ratio of AST/ALT as indexes in clinic study instead of using ALT only.
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Key words:
- liver function /
- immune /
- viral replication
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[1]孙东亮, 杨秀艳.聚合人血清白蛋白受体的检测意义[J].华北煤炭医学院学报, 2003, 5 (5) ∶581-582. [2]Koziel MJ.Cellular immune responses against hepatitis C virus[J].Clin Infect Dis, 2005, 1 (Suppl 1) ∶25-31.
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