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为探讨慢性丙型肝炎自身免疫的发病机制 ,用免疫学方法检测慢性HCV感染者、慢性HBV感染者和健康献血员的血清抗GOR ,ANA和TGA/TMA ,另检测部分慢性HCV感染者和健康献血员血清可溶性Fas(sFas)水平 ;用间接免疫荧光和流式细胞术检测部分慢性HCV感染者和健康献血员外周血淋巴细胞亚群及其凋亡百分率。结果显示 :慢性HCV感染者抗GOR ,ANA和TGA/TMA的阳性率及血清sFas浓度较正常对照组显著增高 (均为 P >0 .0 1) ,较慢性HBV感染者的抗GOR和ANA阳性率亦显著增高 (P <0 .0 1和P <0 .0 5 ) ;慢性HCV感染者PBMCs及CD+ 3 T淋巴细胞凋亡明显高于正常对照组 (P <0 .0 5 ) ,其抗GOR阳性者CD+ 4T淋巴细胞及CD+ 19B淋巴细胞凋亡比抗GOR阴性者明显减少 (P <0 .0 1和P <0 .0 5 )。表明 :慢性HCV感染者存在自身免疫反应及淋巴细胞凋亡不均衡现象 ;CD+ 4T细胞及CD+ 19B细胞凋亡的减少在慢性HCV感染诱导的自身免疫反应中起重要作用。血清sFas水平升高可能是部分淋巴细胞凋亡减少 ,导致自身免疫的原因之一。
In order to explore the pathogenesis of chronic hepatitis C autoimmune, the serum anti-GOR, ANA and TGA / TMA of chronic HCV infected persons, chronic HBV infected persons and healthy blood donors were detected by immunological methods, and some patients with chronic HCV infection and healthy Serum soluble Fas (sFas) levels were determined in blood donors. Peripheral blood lymphocyte subsets and their percentages of apoptosis were detected by indirect immunofluorescence and flow cytometry in patients with chronic HCV infection and healthy blood donors. The results showed that the positive rates of anti-GOR, ANA, TGA / TMA and serum sFas in patients with chronic HCV infection were significantly higher than those in normal controls (all P> 0 01). The anti-GOR and ANA positive rates in patients with chronic HBV infection (P <0.01 and P <0.05). The apoptosis of PBMCs and CD + 3 T lymphocytes in chronic HCV infection was significantly higher than that in the normal control group (P <0.05) GOR-positive CD + 4T lymphocytes and CD 19B lymphocytes apoptosis than anti-GOR negative were significantly reduced (P <0.01 and P <0.05). It indicates that autoimmune reaction and imbalance of lymphocyte apoptosis exist in chronic HCV infection. The decrease of apoptosis of CD + 4T cells and CD + 19B cells plays an important role in the autoimmune response induced by chronic HCV infection. Elevated levels of serum sFas may be part of the decline in lymphocyte apoptosis, leading to autoimmune one of the reasons.