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目的探讨慢性乙型肝炎患者血清补体C3b水平及其临床意义。方法选择乙型肝炎病毒(HBV)感染的慢性乙型肝炎患者140例,据患者血清中HBV e抗原(HBeAg)和丙氨酸氨基转氨酶(ALT)水平,将其分为6组:A组(HBeAg阳性,ALT正常)、B组(HBeAg阴性,ALT正常)、C组(HBeAg阳性,ALT轻、中度升高)、D组(HBeAg阳性,ALT高度升高)、E组(HBeAg阴性,ALT轻、中度升高)、F组(HBeAg阴性,ALT高度或重度升高)。另将20例健康者作为对照组。HBeAg采用酶联免疫吸附测定(ELISA)法,HBV-DNA采用荧光定量聚合酶链反应(PCR)法,ALT采用速率法,补体C3b采用ELISA-生物素亲和素抗体夹心法测定。结果 D组与F组患者血清C3b、ALT、天冬氨酸氨基转氨酶(AST)水平显著高于A、B、C、E组(P<0.05);而D组与F组比较,患者血清C3b、AST水平均无统计学差异(P>0.05)。对照组受检者血清C3b水平显著低于A、B、C、D、E、F组(P<0.05)。C3b水平与ALT、AST、HBsAg存在正相关(P<0.05),而与HBeAg和HBV-DNA无显著相关(P>0.05)。结论补体C3b水平与HBV的感染及肝细胞损伤程度有关,而与病毒复制的活跃程度无关,可作为感染和预后的辅助检测指标。
Objective To investigate the serum level of complement C3b in patients with chronic hepatitis B and its clinical significance. Methods One hundred and seventy patients with chronic hepatitis B infection from hepatitis B virus (HBV) were divided into 6 groups according to their serum levels of HBeAg and ALT: group A HBeAg positive, normal ALT), group B (HBeAg negative, normal ALT), group C (HBeAg positive, mild or moderate ALT), group D (HBeAg positive, elevated ALT), group E ALT mild to moderate increase), F group (HBeAg negative, ALT height or severe increase). Another 20 healthy people as a control group. HBeAg was detected by enzyme-linked immunosorbent assay (ELISA), HBV-DNA was detected by fluorescence quantitative polymerase chain reaction (PCR), ALT by rate method, complement C3b by ELISA-biotin-avidin antibody sandwich method. Results Serum levels of C3b, ALT and aspartate aminotransferase (AST) in group D and group F were significantly higher than those in group A, B, C and E (P <0.05); while in group D and group F, serum C3b , AST levels were no significant difference (P> 0.05). The level of serum C3b in the control group was significantly lower than that in the groups A, B, C, D, E and F (P <0.05). The level of C3b was positively correlated with ALT, AST and HBsAg (P <0.05), but not with HBeAg and HBV-DNA (P> 0.05). Conclusion The level of complement C3b is related to the level of HBV infection and hepatocellular injury, but not to the degree of viral replication. It can be used as an auxiliary index for detection of infection and prognosis.