慢性丙型肝炎患者的血清免疫球蛋白：疾病严重程度和治疗结果的替代标志物。

Serum immunoglobulins in patients with chronic hepatitis C: a surrogate marker of disease severity and treatment outcome.

作者信息

Maruyama Shigeo, Hirayama Chisato, Horie Yutaka, Yorozu Kensho, Maeda Kazunori, Inoue Masayuki, Fujii Yasuyoshi, Umeki Kensuke, Koda Masahiko

机构信息

Department of Gastroenterology, Saiseikai Gotsu General Hospital, Shimane, Japan.

出版信息

Hepatogastroenterology. 2007 Mar;54(74):493-8.

PMID:17523306

Abstract

BACKGROUND/AIMS: Moderate polyclonal hypergammaglobulinemia is a common finding in chronic viral liver disease; however, its clinical significance has not been completely elucidated. We attempted to determine whether serum immunoglobulin levels were correlated with the disease severity and the treatment outcome in patients with chronic hepatitis C.

METHODOLOGY

In a total of 102 patients with chronic hepatitis C, we performed serum tests on immunoglobulins and determined the histology activity index (HAI) score by liver biopsy. In 97 patients, immunoglobulin levels were followed prior to and 6 months after interferon (IFN) therapy.

RESULTS

Serum gamma (y)-globulin and immunoglobulin (IgG) were well correlated with HAI score (both; p < 0.0001), grading score (both; p < 0.01), and staging score (both; p < 0.0001). Among the 97 patients who received 6 months of IFN monotherapy, 31, 29, and 37 patients were complete, transient and non-responders, respectively. In the three subgroups, a significant difference was found in histological HAI, grading, and staging scores (p < 0.01, p < 0.05 and p < 0.0001, respectively), and in serum levels of gamma-globulin and IgG (both; p < 0.0001). Following IFN treatment, serum gamma-globulin and IgG were significantly decreased in the complete responders (both; p < 0.0001). Furthermore, serum levels of gamma-globulin and IgG of 1.5 g/dL were useful for predicting the treatment outcome of IFN monotherapy.

CONCLUSIONS

The measurement of serum gamma-globulin and IgG is a valuable non-invasive tool for assessing the disease severity and treatment outcome in patients with chronic hepatitis C.

摘要

背景/目的：中度多克隆高球蛋白血症是慢性病毒性肝病的常见表现；然而，其临床意义尚未完全阐明。我们试图确定慢性丙型肝炎患者的血清免疫球蛋白水平是否与疾病严重程度及治疗结果相关。

方法

对总共102例慢性丙型肝炎患者进行血清免疫球蛋白检测，并通过肝活检确定组织学活动指数（HAI）评分。对97例患者在干扰素（IFN）治疗前及治疗6个月后监测免疫球蛋白水平。

结果

血清γ球蛋白和免疫球蛋白（IgG）与HAI评分（两者均为p < 0.0001）、分级评分（两者均为p < 0.01）及分期评分（两者均为p < 0.0001）密切相关。在接受6个月IFN单药治疗的97例患者中，分别有31例、29例和37例为完全应答者、短暂应答者和无应答者。在这三个亚组中，组织学HAI、分级及分期评分存在显著差异（分别为p < 0.01、p < 0.05和p < 0.0001），血清γ球蛋白和IgG水平也存在显著差异（两者均为p < 0.0001）。IFN治疗后，完全应答者的血清γ球蛋白和IgG显著降低（两者均为p < 0.0001）。此外，血清γ球蛋白和IgG水平≥1.5 g/dL有助于预测IFN单药治疗的结果。