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目的:研究免疫耐受与应答组HBeAg阳性慢性乙肝患者红细胞补体受体Ⅰ型分子(complement receptor type1,CR1)基因点突变分布特点及数量水平,并分析其临床意义。方法:选择114例肝脏功能正常、血清HBV DNA含量大于106IU/mL的HBeAg阳性慢性乙肝患者作为免疫耐受组研究对象,选择110例初次转氨酶高于正常值2倍以上伴或不伴有肝细胞性黄疸的HBeAg阳性慢性乙肝患者为免疫应答组研究对象。采用PCR和HindⅢ酶切技术对红细胞CR1分子基因点突变进行分类,并采用酶联法定量测定红细胞CR1分子数量水平。结果:免疫耐受组红细胞CR1基因无点突变的患者明显低于应答组(P<0.05);免疫耐受与应答组的女性患者其无点突变百分率明显高于男性患者(P<0.05);在红细胞CR1基因无点突变的患者中,耐受组患者CR1分子数量较应答组明显下降(P<0.05);发生点突变个体的CR1分子数量明显低于未发生点突变的患者(P<0.01)。结论:红细胞CR1基因点突变与HBeAg阳性慢性乙肝患者的免疫反应状态有关,女性患者以无点突变类型为多。
Objective: To investigate the distribution and quantitative level of point mutation in erythrocyte complement receptor type 1 (CR1) gene in patients with HBeAg-positive chronic hepatitis B in immunotolerance and response group and to analyze its clinical significance. Methods: One hundred and eleven patients with HBeAg-positive chronic hepatitis B who had normal liver function and serum HBV DNA level greater than 106 IU / mL were selected as the target group. One hundred and eleven patients with primary aminotransferase (ALT) were more than 2 times of the normal value with or without hepatocyte Jaundice HBeAg-positive patients with chronic hepatitis B immune response to the study object. PCR and Hind Ⅲ digestion technology were used to classify the point mutations of erythrocyte CR1 gene, and the quantity of CR1 in erythrocytes was quantitatively determined by enzyme-linked immunosorbent assay. Results: There was no significant difference in CR1 gene polymorphism among immunocompromised patients (P <0.05). The percentage of point - free mutations in immunocompromised patients was significantly higher than that in male patients (P <0.05). The number of CR1 molecules in tolerated patients was significantly lower than that in response patients (P <0.05). The number of CR1 in point mutation patients was significantly lower than that in patients without mutation (P <0.01) ). Conclusion: The point mutation of erythrocyte CR1 gene is associated with the immune response in HBeAg-positive chronic hepatitis B patients. There are many types of mutation in female patients.