Tsianos E V, Di Bisceglie A M, Papadopoulos N M, Costello R, Hoofnagle J H
Liver Diseases Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.
Am J Gastroenterol. 1990 Aug;85(8):1005-8.
We studied serum immunoglobulins in 54 patients with chronic viral hepatitis. The majority had hyperglobulinemia, with immunoglobulin G (IgG) being elevated the most. High resolution protein electrophoresis revealed the presence of oligoclonal bands within the gamma-globulin region of the electrophoretic pattern (oligoclonal immunoglobulin bands) in 32 (59%) patients. Between two and seven bands were noted in each sample. In order to analyze the significance of this observation, we performed stepwise discriminant analysis of clinical, demographic, serological, and serum biochemical features in patients with and without detectable oligoclonal immunoglobulin bands. The patient's ages and serum immunoglobulin G levels were found to be important predictors of the presence of oligoclonal immunoglobulin bands. No correlation was found with the type of hepatitis, disease severity, or duration of hepatitis. On follow-up, serum samples were retested in 20 patients, over 5 to 60 months. Significant change was noted in only one patient in whom oligoclonal immunoglobulin bands (initially very prominent) became progressively weaker and finally disappeared over a 5-yr period. This was associated with an improvement in his hepatitis after loss of hepatitis following loss of hepatitis B e antigen from serum. These observations suggest that the determination of oligoclonal immunoglobulin bands in serum may be a useful marker to study the course and activity of chronic viral hepatitis in selected patients.
我们对54例慢性病毒性肝炎患者的血清免疫球蛋白进行了研究。大多数患者存在高球蛋白血症，其中免疫球蛋白G（IgG）升高最为明显。高分辨率蛋白质电泳显示，32例（59%）患者的电泳图谱γ球蛋白区域内存在寡克隆带（寡克隆免疫球蛋白带）。每个样本中可观察到2至7条带。为了分析这一观察结果的意义，我们对有或无可检测到的寡克隆免疫球蛋白带的患者的临床、人口统计学、血清学和血清生化特征进行了逐步判别分析。发现患者的年龄和血清免疫球蛋白G水平是寡克隆免疫球蛋白带存在的重要预测因素。未发现与肝炎类型、疾病严重程度或肝炎病程相关。在随访中，对20例患者的血清样本进行了5至60个月的重新检测。仅1例患者出现显著变化，其寡克隆免疫球蛋白带（最初非常明显）在5年期间逐渐变弱并最终消失。这与血清中乙肝e抗原消失后肝炎病情改善相关。这些观察结果表明，血清中寡克隆免疫球蛋白带的测定可能是研究部分慢性病毒性肝炎患者病程和活动的有用标志物。
