HBV相关慢加急肝衰竭患者血浆抗可溶性肝抗原抗体的检测及意义

摘要

Objective To evaluate the significance of serum anti-SLA level in patients with HBV-related acute-on-chronic liver failure (H-A).Methods A total of 26 patients with H-A (H-A group), 16 patients with chronic hepatitis B (CHB group), 17 patients with liver cirrhosis (LC group) and 14 healthy controls were enrolled (HC group).The serum level of anti-SLA was detected by enzyme linked immunosorbent assay.Results The optical density value level of anti-SLA in patients with HBV infection was significantly higher than that of HC group (P<0.001).Moreover, the level of anti-SLA in H-A group was significantly higher than those in CHB group (P<0.001) and LC group (P<0.001).The level of anti-SLA was positively correlated with ALT (r=0.260, P=0.046) and TBIL (r=0.646, P<0.001), but not correlated with HBV-DNA (r=-0.069, P=0.598) in patients with HBV infection.In H-A group, the level of anti-SLA was positively correlated with total bile acid (r=0.478, P=0.024), but not correlated with prothrombin activity (PTA), ALT, AST, DBIL or TBIL.Conclusion It is suggested that the difference of anti-SLA expression among the patients with HBV infection could be assessed using this method, and the high level of anti-SLA in H-A patients might be correlated with the progression and prognosis of acute-on-chronic liver failure.%目的 评价血浆抗可溶性肝抗原抗体(抗SLA)检测在乙型肝炎病毒(HBV)相关慢加急肝衰竭(H-A)患者中的意义.方法 使用抗SLA酶联免疫检测试剂盒,检测H-A患者(H-A组)、肝硬化(LC)患者(LC组)、慢性乙型肝炎(CHB)患者(CHB组)和健康对照者(HC组)血浆抗SLA,分析不同临床组间抗SLA的表达差异,以及与肝功能相关指标的关系.结果 慢性HBV感染(CHB+LC+H-A)组的抗SLA水平均显著高于HC组(P<0.001),而H-A组抗SLA的OD值显著高于CHB组(P<0.001)、LC组(P<0.001);在HBV感染者中,抗SLA的OD值水平与ALT(r=0.260,P=0.046)及TBIL(r=0.646,P<0.001)水平呈正相关,与HBV-DNA无明显相关性(r=-0.069,P=0.598).在H-A组,抗SLA的OD值水平与总胆汁酸呈正相关(r=0.478,P=0.024),与凝血酶原活动度、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、直接胆红素(DBIL)、总胆红素(TBIL)无显著相关性.结论 这种检测方法可用于评估不同慢性HBV感染者抗SLA的表达差异,H-A患者高表达抗SLA可能与肝细胞的严重损伤及免疫发病机制相关.