Tănăsescu C, Micu D, Codreanu C, Ilinca D, Manolescu N, Schioiu L, Purice S
N. Gh. Lupu Institute of Internal Medicine, Bucharest, Romania.
Med Interne. 1988 Jan-Mar;26(1):53-66.
Observations were made in a group of 120 patients with active chronic hepatitis (ACH), using demonstration of HBsAg presence, structural study of the peripheral blood mononuclear cell population by means of scanning electron microscopy (SEM) and typing of HLA-A, B and C antigens. From the whole group 22 patients were proved to have an autoimmune form of ACH secondary to infection with hepatitis B virus (HBV). The authors consider that the diagnostic value of the ratio between B and T lymphocytes (studied by SEM) is relative but the demonstration of an increased percentage of monocytomacrophage cells and the presence of "killing phenomenon" clearly reflect a more severe hepatic inflammation. A higher incidence of the HLA-Bw35-Cw4 was observed particularly in the HBsAg positive forms of ACH and in the HBsAg positive secondary autoimmune forms. The authors discuss the utility of these observations when the opportunity of corticotherapy has to be established.
对120例活动性慢性肝炎（ACH）患者进行了观察，方法包括检测HBsAg的存在、利用扫描电子显微镜（SEM）对外周血单个核细胞群体进行结构研究以及对HLA - A、B和C抗原进行分型。在整个研究组中，有22例患者被证实患有继发于乙型肝炎病毒（HBV）感染的自身免疫性ACH。作者认为，B淋巴细胞与T淋巴细胞的比例（通过SEM研究）的诊断价值是相对的，但单核巨噬细胞比例增加以及“杀伤现象”的存在清楚地反映了更严重的肝脏炎症。尤其在ACH的HBsAg阳性形式和HBsAg阳性继发性自身免疫形式中，观察到HLA - Bw35 - Cw4的发生率更高。作者讨论了在确定是否进行皮质激素治疗时这些观察结果的实用性。
