目的 研究慢性丙型肝炎病毒感染者体内自身免疫抗体的动态变化,及其与HCV-RNA基因型的关系.方法 62例慢性(丙型病毒性肝炎患者HCV感染经RT-PCR证实.HCV基因型的检测采用Simmonds基因分型法.抗线粒体抗体(AMA)、抗肝肾微粒体抗体(LKM)、抗可溶性肝抗原(SLA)、抗去唾液酸糖蛋白受体抗体(ASG)和抗肝细胞膜抗原抗体(LMA)采用ELISA检测.结果 62例慢性丙型病毒性肝炎患者中,54例(87.75%)为Ⅰ型HCV感染,其中Ⅰa型4例(6.45%),Ⅰb型38例(61.27%),Ⅰc型12例(19.35%);4例(6.45%)为Ⅱa型;1例(1.63%)为混合型(Ⅰb型+Ⅱa型);2例(3.25%)为未分型.同时检测出Ⅰ型HCV感染的54例中有21例检出自身抗体阳性(38.9%),Ⅱa型HCV感染的4例中有1例检出自身抗体阳性(25%).Ⅰb型和Ⅱa型混合感染的1例及未分型的2例均为阴性.62例HCV感染者中自身抗体阳性者共22例(35.48%),其中男7例(24.14%),女15例(44.45%),两者比较差异有统计学意义(P＜0.05).阳性患者平均年龄为(55.67±6.75)岁明显高于阴性患者(40.21±7.51)岁,差异有统计学意义(P＜0.05).结论 在该地区的慢性丙型病毒性肝炎患者中,基因型分布以Ⅰb型为主.HCV感染者中普遍存在自身抗体,自身抗体的出现与年龄及性别有明显关系,但与HCV基因型无明显相关.基因Ⅰ型HCV感染者抗病毒治疗可诱发自身抗体水平的升高,但它是一过性的现象,在抗病毒治疗结束后部分自身抗体可降低甚至消失.%Objective To study the chronic virus hepatitis C infected patients immune antibody dynamic change,and the relationship between immune antibody and HCV-RNA gene type. Methods 62 cases patients be confirmed of HCV infection by RT - PCR. The HCV genotype detected use of the Simmonds genotyped method. The ELISA analysis method be use to detected anti-mitochon-drial antibody( AMA) ,anti-liver and kidney micro-antibodies(LKM),anti-soluble liver antigen(SLA/LP) , anti saliva acid glycopro-tein receptor antibodies(ASG) and anti-liver cell membrane antigen antibody(LMA). Results In 62 cases patients of chronic viral hepatitis C,54 cases(87. 75%) for I type HCV infection,in which 4 cases(6.45%) forⅠa,38 cases (61. 27%) for I b, f 2 cases (19. 35%) for Ⅰ c; another 4 patients(6. 45%) for Ⅱ a,1 cases (1. 63%) for hybrid( I b type + Ⅱ a type); 2 cases(3. 25%) were not parting. At the same time,HCV genotype I infector in 54 cases have 21 cases detected autoantibody positive(38. 9%),HCV genotype Ⅱ a infector in 4 cases havel case detected autoantibody positive(25%). I b type and Ⅱ a type mixed infection and 1 case not parting 2 cases are negative. There are 22 cases of autoantibodies positive in 62 cases of HCV infector, the male 7 cases (24. 14%),female 15 cases(44. 45%) ,both comparative differences have statistical significance(P<0. 05). Positive patients[mean age (55. 67 + 6. 75)years old] is obviously higher than that of the negative patients[(40. 21 + 7. 51) years old],(P<0. 05). Conclusion This study indicates that genotype I b is major HCV genotypes in district s of chronic viral hepatitis C patients. HCV infector commonly exist autoantibody,the emergence of autoantibodies with age and gender have obvious relationship,but the emergence no significant correlation with HCV genotypes. HCV genotype I infectors may induce autoantibody level by antiviral treatment, but it is a transient phenomenon,the autoantibodies can reduce or disappear after the end part of by antiviral treatment.
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