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

伍慧丽; 郑素军; 王泰龄; 闫惠平; 任峰; 李俊峰; 陈煜; 刘梅; 刘霜; 段钟平

doi:10.3969/j.issn.1001-5256.2018.02.013

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

DOI: 10.3969/j.issn.1001-5256.2018.02.013

1. 首都医科大学附属北京佑安医院人工肝中心
2. 卫生部中日友好医院病理科
3. 首都医科大学附属北京佑安医院感染与免疫研究中心
4. 首都医科大学附属北京佑安医院肝病研究所
5. 兰州大学附属第一医院

基金项目:

2017年度创新基地培育和发展专项(Z171100002217070)；

详细信息

中图分类号: R512.63
计量
- 文章访问数: 2238
- HTML全文浏览量: 37
- PDF下载量: 432
- 被引次数: 0
出版历程
- 出版日期: 2018-02-20

Pathological features of liver tissue in autoantibody-positive chronic hepatitis C patients after plasmaphoresis

Artificial Liver Treatment & Training Center, Beijing YouAn Hospital, Capital Medical University

Research funding:

摘要

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...
- 血浆 /
- 肝炎,丙型,慢性 /
- 自身抗体 /
- 病理状态,体征和症状
Abstract:
Objective To 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.Methods A 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 January1992 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.Results Of 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) .Conclusion Autoantibody-positive are common in CHC patients after plasmaphoresis, and autoantibody-positive patients tend to have more severe injuries of the liver.
- plasma /
- hepatitis C, chronic /
- autoantibodies /
- pathological conditions, signs and symptoms

HTML全文

参考文献(29)

[1]LAVANCHY D.The global burden of hepatitis C[J].Liver Int, 2009, 29 (Suppl 1) :74-81.

[2]MOHD HANAFIAH K, GROEGER J, FLAXMAN AD, et al.Global epidemiology of hepatitis C virus infection:new estimates of age-specific antibody to HCV seroprevalence[J].Hepatology, 2013, 57 (4) :1333-1342.

[3]GOMEZ EV, RODRIGUEZ YS, BERTOT LC, et al.The natural history of compensated HCV-related cirrhosis:a prospective long-term study[J].J Hepatol, 2013, 58 (3) :434-444.

[4]DASCHAKRABORTY S, AGGARWAL A, AGGARWAL R.Non-organ-specific autoantibodies in indian patients with chronic liver disease[J].Indian J Gastroenterol, 2012, 31 (5) :237-242.

[5]MARCONCINI ML, FAYAD L, SHIOZAWA MB, et al.Autoantibody profile in individuals with chronic hepatitis C[J].Rev Soc Bras Med Trop, 2013, 46 (2) :147-153.

[6]SANSONNO L, TUCCI FA, SANSONNO S, et al.B cells and HCV:an infection model of autoimmunity[J].Autoimmun Rev, 2009, 9 (2) :93-94.

[7]BAYRAKTAR Y, BAYRAKTAR M, GURAKAR A, et al.A comparison of the prevalence of autoantibodies in individuals with chronic hepatitis C and those with autoimmune hepatitis:the role of interferon in the development of autoimmune diseases[J].Hepatogastroenterology, 1997, 44 (14) :417-425.

[8]YEE LJ, KELLENHER P, GOLDIN RD, et al.Antinuclear antibodies (ANA) in chronic hepatitis C virus infection:correlates of positivity and clinical relevance[J].J Viral Hepat, 2004, 11 (5) :459-464.

[9]PENG YC, HAIEH SC, YANG DY, et al.Expression and clinical significance of antinuclear antibody in hepatitis C virus infection[J].J Clin Gastroenterol, 2001, 33 (5) :402-406.

[10]CASSANI F, CATALETA M, VALENTINI P, et al.Serum autoantibodies in chronic hepatitis C:comparison with autoimmune hepatitis and impact on the disease profile[J].Hepatology, 1997, 26 (3) :561-566.

[11]RIGOPOULOU EI, MYTILINAIOU M, ROMANIDOU O, et al.Autoimmune hepatitis-specific antibodies against soluble liver antigen and liver cytosol type 1 in patients with chronic viral hepatitis[J].J Autoimmune Dis, 2007, 4:2.

[12]NARCISO-SCHIAVON JL, SCHIAVON LDE L.Autoantibodies in chronic hepatitis C:a clinical perspective[J].World J Hepatol, 2015, 7 (8) :1074-1085.

[13]STROFFOLINI T, COLLOREDO G, GAETA GB, et al.Does an‘autoimmune’profile affect the clinical profile of chronic hepatitis C?An italian multicentre survey[J].J Viral Hepat, 2004, 11 (3) :257-262.

[14]Chinese Society of Hepatology and Chinese Society of Infectious Diseases Chinese, Medical Association.The guideline of prevention and treatment for hepatitis C:a 2015 update[J].J Clin Hepatol, 2015, 31 (12) :1961-1979. (in Chinese) 中华医学会肝病学分会, 中华医学会感染病学分会.丙型肝炎防治指南 (2015年更新版) [J].临床肝胆病杂志, 2015, 31 (12) :1961-1979.

[15]ISHAK K, BAPTISTA A, BIANCHI L, et al.Histological grading and staging of chronic hepatitis[J].J Hepatol, 1995, 22 (6) :696-699.

[16]BRUNT EM.Pathology of fatty liver disease[J].Mod Pathol, 2007, 20 (Suppl 1) :s40-s48.

[17]VERGANI D, ALVAREZ F, BIANCHI FB, et al.Liver autoimmune serology:a consensus statement from the committee for autoimmune serology of the international autoimmune hepatitis group[J].J Hepatol, 2004, 41 (4) :677-683.

[18]KUNIHOLM MH, GAO X, XUE X, et al.The relation of HLA genotype to hepatitis C viral load and markers of liver fibrosis in HIV-infected and HIV-uninfected women[J].J Infect Dis, 2011, 203 (12) :1807-1814.

[19]KERKAR N, CHOUHURI K, MA Y, et al.Cytochrome p4502d6 (193-212) :a new immunodominant epitope and target of virus/self cross-reactivity in liver kidney microsomal autoantibody type 1-positive liver disease[J].J Immunol, 2003, 170 (3) :1481-1489.

[20]SUTTI S, VIDALI M, MOMBELLO C, et al.Conformational anticytochrome P4502E1 (CYP2E1) auto-antibodies contribute to necro-inflammatory injury in chronic hepatitis C[J].J Viral Hepat, 2010, 17 (10) :685-690.

[21]MIZUOCHI T, ITO M, TAKAI K, et al.Differential susceptibility of peripheral blood CD5+and CD5-B cells to apoptosis in chronic hepatitis C patients[J].Biochem Biophys Res Commun, 2009, 389 (3) :512-515.

[22]CLAASSEN MA, DE KNEGT RJ, TILANUS HW, et al.Abundant numbers of regulatory T cells localize to the liver of chronic hepatitis C infected patients and limit the extent of fibrosis[J].J Hepatol, 2010, 52 (3) :315-321.

[23]WILLIAMS MJ, LAWSON A, NEAL KR, et al.Autoantibodies in chronic hepatitis C virus infection and their association with disease profile[J].J Viral Hepat, 2009, 16 (5) :325-331.

[24]LI WS, ZHAO JM, ZHOU GD, et al.The impact of autoantibodies on liver histology in hepatitis C[J/CD].Chin J Clinicians:Electronic Edition, 2011, 5 (20) :5969-5973. (in Chinese) 李文淑, 赵景民, 周光德, 等.HCV感染者自身抗体对肝脏损伤的影响[J/CD].中华临床医师杂志:电子版, 2011, 5 (20) :5969-5973.

[25]ROSKAMS TA, THEISE ND, BALABAUD C, et al.Nomenclature of the finer branches of the biliary tree:canals, ductules, and ductular reactions in human livers[J].Hepatology, 2004, 39 (6) :1739-1745.

[26]GOUW AS, CLOUSTON AD, THEISE ND.Ductular reactions in human liver:diversity at the interface[J].Hepatology, 2011, 54 (5) :1853-1863.

[27]AZMAIPARASHVILI E, BERISHVILI E, KAKABADZE Z, et al.Ductular reaction at the early terms of common bile duct ligation in the rats[J].Acta Biol Hung, 2012, 63 (3) :321-332.

[28]AFSARI A, LEE E, SHOKRANI B, et al.Clinical and pathological risk factors associated with liver fibrosis and steatosis in african-americans with chronic hepatitis C[J].Dig Dis Sci, 2017, 62 (8) :2159-2165.

[29]KAROUI S, TAIEB JOMI M, BELLIL K, et al.Steatosis in chronic viral hepatitis C:frequency, risk factors and relationship with fibrosis[J].Tunis Med, 2008, 86 (7) :670-675.

施引文献

资源附件(0)

访问统计