慢性肝炎和肝硬化发病机制中针对乙肝表面抗原的抗体形成缺陷？

Deficiency of antibody formation to HBsAg in the pathogenesis of chronic hepatitis and cirrhosis?

作者信息

Schlicht I, Gadow J, Ortmans H, Jorno L, Gentz H D, Wolter G, Hoppe I

出版信息

Acta Hepatogastroenterol (Stuttg). 1979 Dec;26(6):450-6.

Abstract

UNLABELLED

Sera of 832 healthy persons and patients suffering from chronic inflammatory liver disease were investigated by radioimmunoassay for HBsAg and anti-HBs. Diagnosis in patients was secured by biopsy. The persons were divided into: 1. Healthy persons: n = 478 blood donors, hospital especially exposed to HBV, patients with healed hepatitis; 2.

PATIENTS

n = 354 acute hepatitis, chronic persistent and aggressive hepatitis, post-hepatitic, cryptogenic and alcoholic cirrhosis. The results demonstrate considerable accumulation of HBsAg in chronic liver disease (72% in CAH, 66% in posthepatic liver cirrhosis) whereas anti-HBs was more frequently observed in healthy persons (38% in hospital staff, 49% in healed hepatitis). Furthermore, HBsAg and anti-HBs were frequently observed simultaneously in chronic hepatitis and cirrhosis (23% in CAH). A strong shift in the relation of antigen to antibody to the disadvantage of antibody in the examined collectives of chronic hepatitis and cirrhosis is evident. Chronic inflammatory HBsAg positive liver disease should therefore be regarded as chronic virus infection. We suppose an absolute or relative deficiency of antibody to HBsAg is probably an important factor for the development of chronicity of hepatitis B.

摘要

未标记

采用放射免疫分析法对832名健康人和慢性炎症性肝病患者的血清进行乙肝表面抗原（HBsAg）和乙肝表面抗体（抗-HBs）检测。通过活检确诊患者病情。这些人被分为：1. 健康人：n = 478，包括献血者、医院中特别易感染乙肝病毒者、已治愈肝炎患者；2. 患者：n = 354，包括急性肝炎、慢性持续性肝炎和活动性肝炎、肝炎后肝硬化、原因不明肝硬化和酒精性肝硬化患者。结果显示，慢性肝病中乙肝表面抗原大量积聚（慢性活动性肝炎中为72%，肝炎后肝硬化中为66%），而健康人中乙肝表面抗体更为常见（医院工作人员中为38%，已治愈肝炎患者中为49%）。此外，慢性肝炎和肝硬化患者中乙肝表面抗原和乙肝表面抗体常同时出现（慢性活动性肝炎中为23%）。在慢性肝炎和肝硬化的受检人群中，抗原与抗体的关系明显向不利于抗体的方向大幅转变。因此，慢性炎症性乙肝表面抗原阳性肝病应被视为慢性病毒感染。我们认为乙肝表面抗原抗体的绝对或相对缺乏可能是乙肝慢性化发展的一个重要因素。