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目的探讨HCV感染诱导自身免疫度应的机理。方法应用ELISA和流式细胞术检测了18例慢性丙型肝炎患者及16例正常人血清丙型肝炎病毒感染相关自身抗体（抗GOR）及抗核抗体（ANA）、外周血淋巴细胞（PBMC）亚群及其凋亡百分率。结果慢性丙型肝炎患者血清抗GOR抗体及ANA阳性率分别为66.7％和44.4％,与正常对照组比较差异均有显著意义（x~2＝26.86、x~2＝9.30，P＜0.005）。PBMC及CD_3~＋T淋巴细胞凋亡明显增加，与正常对照组比较差异有显著意义（t＝2．44，P＜0.05）。抗GOR阳性者CD_4~＋T淋巴细胞及CD_(19)~＋B淋巴细胞凋亡比抗GOR阴性者明显减少（t＝ 3．17P＜0.01；t＝2.294，P＜0.05）。抗GOR阳性者CD_4~＋CD_8~＋双阳性T细胞百分率较抗GOR阴性者显著增加（t＝2.44，P＜0.05），CD_3~＋／CD_4~＋T细胞显著降低（t＝2.18P＜0.05）。结论慢性丙型肝炎患者存在自身免疫，同时伴有外用血淋巴细胞亚群及其细胞凋亡的失衡。这种失衡可能是HCV感染诱导自身免疫的机理之一。
Objective To investigate the mechanism of induction of autoimmune response in HCV infection. Methods Serum levels of anti-GOR, ANA, PBMC were measured in 18 patients with chronic hepatitis C and 16 healthy controls by ELISA and flow cytometry. Subpopulations and their percentages of apoptosis. Results The positive rates of serum anti-GOR antibody and ANA in patients with chronic hepatitis C were 66.7% and 44.4%, respectively, which were significantly different from those in the control group (x ~ 2 = 26.86, x ~ 2 = 9.30, P <0.005). The apoptosis of PBMC and CD_3 ~ + T lymphocytes was significantly increased compared with the normal control group (t = 2.44, P <0.05). Apoptosis of CD_4 ~ + T lymphocytes and CD_ (19) ~ + B lymphocytes in anti-GOR positive patients were significantly lower than those in anti-GOR negative patients (t = 3.17P <0.01; t = 2.294, P <0.05). The percentage of CD_4 ~ + CD_8 ~ + double positive T cells in anti-GOR positive patients was significantly higher than that in anti-GOR negative patients (t = 2.44, P <0.05), while CD_3 ~ + / CD_4 ~ + T cells were significantly decreased (t = 2.18P <0.05). Conclusion There is autoimmunity in patients with chronic hepatitis C, accompanied by imbalance of peripheral blood lymphocyte subsets and apoptosis. This imbalance may be one of the mechanisms by which HCV infection induces autoimmunity.