IgG4与免疫性肝损伤疾病的关系

摘要

Objective To analyze the level of immunoglobulin G4 (IgG4) in serum from patients with 3 types of immunological liver injury, and to investigate its correlation with different types of immunological liver injury and the clinical significance.Methods A total of 220 patients with immunological liver injury in our hospital were enrolled, including 80 patients with chronic hepatitis B (CHB), 60 patients with autoimmune hepatitis (AIH) and 80 patients with primary biliary cirrhosis (PBC).The serum biochemical index, serum IgG4 level and autoantibodies of the 3 groups were retrospectively analyzed for comparative analysis of the relationship between IgG4 and diseases.Results The median level of IgG4 in AIH group was 3.24 (1.78～4.53), which was significantly higher than that in other 2 groups (P＜0.05).The median level of IgG4 in PBC group was 2.19 (0.69～3.01), which was higher than that in CHB group (1.40) (0.55～3.05).Within the group, serum IgG4 levels showed a certain correlation with liver function and autoantibody positive rate.Conclusion The correlation between AIH and IgG4 is the most relevant among the 3 groups.Thus, detection of IgG4 content is of great significance in the diagnosis of immunological liver injury, such as AIH, and the evaluation of therapeutic effect.%目的 探讨血清IgG4水平与不同类型免疫性肝损伤的相关性及临床意义.方法 收集解放军八一医院免疫性肝损伤患者220例, 其中慢性乙型肝炎 (CHB) 80例, 自身免疫性肝炎 (AIH) 60例、原发性胆汁性肝硬化 (PBC) 80例.回顾性分析3组患者的血清生化指标、血清IgG4水平、自身抗体等差异.分析IgG4与各类疾病的相关性.结果 AIH组IgG4水平为3.24 (1.78～4.53), 相对于其他两组升高最为明显 (P＜0.05), PBC组IgG4水平为2.19 (0.69～3.01), 高于CHB组的1.40 (0.55～3.05), 但低于AIH组.组内分析发现, 血清IgG4水平与患者肝功能、自身抗体阳性率具有一定相关性.结论 AIH与IgG4含量的相关性最明显, IgG4含量的检测对辅助诊断AIH等免疫性肝损伤以及疗效具有一定意义.