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)；

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中图分类号: R512.63
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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

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