乙型肝炎病毒感染与自身免疫的相关性研究
Relative Study between Hepatitis B Virus Infection and Autoimmunity

目的：研究乙型肝炎病毒(HBV)感染与自身免疫发生的相关性。方法：选取100例HBV感染者作为实验组，检测乙肝五项定量指标和病毒DNA (HBV-DNA)；同时选取50例健康体检者作为对照组。两组均采用间接免疫荧光方法进行抗核抗体(ANA)检测。结果：实验组ANA阳性率49%，与对照组(24%)比较，差异有统计学意义(P < 0.05)。ANA滴度以1:40为主(59.2%)，1:80和1:160的占比分别为24.5%和10.2%；健康对照组亦以低滴度为主，1:40和1:80占比分别为41.7%和58.3%。荧光核型以核均质型、颗粒型和胞浆颗粒型为主，其阳性率分别为：43.7%，22.4%和16.3%。乙肝五项定量的结果中，1 + 2 + 3 + 4 + 5的ANA阳性率最高，为100%；其次是1 + 2 + 3 + 5，阳性率为67.0%；1 + 3 + 5、1 + 3 + 4 + 5、1 + 4 + 5的阳性率分别为61.9%、50.0%和41.1%。HBV-DNA ≥ 1.0 × 10²且<1.0 × 10⁵拷贝标本中ANA阳性23例(53.5%)，≥1.0 × 10⁵且<1.0 × 10⁷拷贝的9例(64.3%)，≥1.0 × 10⁷且<1.0 × 10⁹拷贝的8例(44.4%)；各组间比较统计学无明显差异(P > 0.05)。结论：乙型肝炎病毒感染可以导致自身免疫的发生，但不同的乙肝五项定量模式和血清HBV-DNA载量与自身免疫无明显相关性。
Objective: To study the possible relativity between hepatitis B virus (HBV) infection and autoim-munity. Methods: 100 patients infected with HBV were selected as the experimental group, serum five quantitative indicators and HBV-DNA of hepatitis B virus were detected. Meanwhile, 50 healthy subjects were selected as control group. Anti-nuclear antibody (ANA) was detected with indirect immunofluorescence assay. Results: The positive rate of ANA in the experimental group was 49%, which was significantly higher than 24% of the control group (P < 0.05). ANA titer was mainly 1:40 (59.2%), and the proportions of 1:80 and 1:160 were 24.5% and 10.2%, respectively. The healthy control group were also dominated by low titers, the proportion of 1:40 was 41.7% and that of 1:80 was 58.3%. The ANA patterns were mainly nuclear homogenous, granular and cytoplasmic granular, and the corresponding positive rate was 43.7%, 22.4% and 16.3%. For the five quantitative results of hepatitis B virus, the positive rate of ANA of 1 + 2 + 3 + 4 + 5 was the highest, which was 100%. The positive rate of 1 + 2 + 3 + 5 was 67.0%. The positive rates of 1 + 3 + 5, 1 + 3 + 4 + 5 and 1 + 4 + 5 were 61.9%, 50.0% and 41.1%, respectively. There were different ANA positive ratios in different HBV-DNA load: 23 cases (53.5%) for ≥1.0 × 10² and <1.0 × 10⁵ copies, 9 cases (64.3%) for ≥1.0 × 10⁵ and <1.0 × 10⁷ copies, 8 cases (44.4%) for ≥1.0 × 10⁷ and <1.0 × 10⁹ copies. There was no significant difference among all groups (P > 0.05). Conclusion: Hepatitis B virus infection can lead to the occurrence of autoimmunity, but the relativity between autoimmunity between HBV five quantitative indices and serum HBV-DNA load is not found in this study.