Irshad M, Acharya S K, Joshi Y K, Tandon B N
Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi.
J Gastroenterol Hepatol. 1994 Jul-Aug;9(4):355-60. doi: 10.1111/j.1440-1746.1994.tb01255.x.
The present study describes the plasma levels of soluble fibronectin (FN), C3d, the breakdown product of C3 complement and Ba, the breakdown product of properdin factor B, in 30 patients of uncomplicated acute viral hepatitis (AVH), 64 patients of fulminant hepatic failure (FHF) and 29 patients of subacute hepatic failure (SAHF) with different hepatitis viral infections. Aetiological analysis of these patients demonstrated hepatitis B, hepatitis C and hepatitis non-A, non-B, non-C (NANB-NC) infections in 6.7, 13.3 and 80% cases, respectively, of the AVH group; 18.8, 42.2. and 39.0% cases, respectively, of the FHF group; and 31.0, 34.5 and 34.5% cases of the SAHF group. None of them had hepatitis A infection. The analysis of data showed that the plasma FN level was significantly reduced in patients with FHF and SAHF as compared to AVH patients and healthy persons. Fibronectin levels in AVH was comparable to that in the healthy group. Further, the FN level was not dependent on the nature of aetiological virus. The level of C3d in plasma was significantly high in all patients of FHF and SAHF, irrespective of their viral aetiology, compared to the AVH group and the healthy group. Like FN, the C3d level was comparable in the AVH and healthy groups. However, the Ba level was comparable to the normal value in all types of infections including the AVH, FHF and SAHF groups. These findings were used to explain the possible roles of fibronectin and complement in the immunopathogenesis of liver injury in patients of acute liver failure of viral aetiology.
本研究描述了30例无并发症的急性病毒性肝炎（AVH）患者、64例暴发性肝衰竭（FHF）患者和29例亚急性肝衰竭（SAHF）患者血浆中可溶性纤连蛋白（FN）、C3补体裂解产物C3d以及备解素因子B裂解产物Ba的水平，这些患者存在不同的肝炎病毒感染。对这些患者的病因分析表明，在AVH组中，分别有6.7%、13.3%和80%的病例感染乙型肝炎、丙型肝炎和非甲、非乙、非丙型肝炎（NANB-NC）；在FHF组中，分别有18.8%、42.2%和39.0%的病例；在SAHF组中，分别有31.0%、34.5%和34.5%的病例。他们均无甲型肝炎感染。数据分析表明，与AVH患者和健康人相比，FHF和SAHF患者的血浆FN水平显著降低。AVH患者的纤连蛋白水平与健康组相当。此外，FN水平不依赖于致病病毒的性质。与AVH组和健康组相比，FHF和SAHF的所有患者血浆中C3d水平均显著升高，无论其病毒病因如何。与FN一样，AVH组和健康组的C3d水平相当。然而，在包括AVH、FHF和SAHF组在内的所有类型感染中，Ba水平与正常值相当。这些发现用于解释纤连蛋白和补体在病毒性病因急性肝衰竭患者肝损伤免疫发病机制中的可能作用。
