Caballería L, Parés A, Ercilla G, Montull S, Caballería J, Rodés J
Unidad de Alcohología y Hepatología, Hospital Clínic i Provincial, Universidad de Barcelona.
Gastroenterol Hepatol. 1997 Apr;20(4):167-71.
The association between the class I and class II histocompatibility antigens (HLA) and the severity of alcoholic liver disease was studied in 102 alcoholic patients (64 males and 38 females) with liver disease. According to histologic diagnosis 41 patients had a mild hepatic lesion (12 with minimum changes, 15 with steatosis and 14 with fibrosis) and 61 patients had severe hepatic lesion (13 with alcoholic hepatitis, 35 with cirrhosis and 13 with cirrhosis and alcoholic hepatitis). No differences were found between the two groups in regards to sex, quantity and length of alcohol consumption, although the patients with mild hepatic lesion were younger than those with severe hepatic lesion (41.2 +/- 8.2 and 47.8 +/- 11.6 years, respectively). The prevalence of the A30, B16, B47, Bw56, Cw1, Cw5 and Cw7 antigens was higher in the alcoholics than in the controls, although only the A30 (12.7% vs. 4.4%, p < 0.04) and the Bw56 antigens (3.9% vs 0.1%, p < 0.001) remained significant when the p value was corrected by the number of antigens studied. These differences were due to a greater prevalence of the A30 antigens (17.0% vs. 4.4%, p < 0.001), B16 (24.3% vs. 7.5%, p < 0.01) and Bw56 (7.3% vs 0.1%, p < 0.001) in patients with mild hepatic lesion versus the controls. In contrast, these antigens were present in similar numbers in patients with severe hepatic lesion and in the controls. On the other hand, no differences were observed regarding the prevalence of the class II HLA antigens between the alcoholics and the controls, or between the two alcoholic groups. These data suggest that the alcoholics with A30, B16 and Bw56 antigens are less susceptible to developing severe liver disease.
对102例患有肝脏疾病的酒精性患者(64例男性和38例女性)进行了研究,以探讨I类和II类组织相容性抗原(HLA)与酒精性肝病严重程度之间的关联。根据组织学诊断,41例患者有轻度肝脏病变(12例有最小变化,15例有脂肪变性,14例有纤维化),61例患者有严重肝脏病变(13例有酒精性肝炎,35例有肝硬化,13例有肝硬化合并酒精性肝炎)。两组在性别、饮酒量和饮酒时间方面未发现差异,尽管轻度肝脏病变患者比严重肝脏病变患者年轻(分别为41.2±8.2岁和47.8±11.6岁)。酒精性患者中A30、B16、B47、Bw56、Cw1、Cw5和Cw7抗原的患病率高于对照组,尽管在通过研究的抗原数量校正p值后,只有A30(12.7%对4.4%,p<0.04)和Bw56抗原(3.9%对0.1%,p<0.001)仍具有显著性。这些差异是由于轻度肝脏病变患者中A30抗原(17.0%对4.4%,p<0.001)、B16(24.3%对7.5%,p<0.01)和Bw56(7.3%对0.1%,p<0.001)的患病率高于对照组。相比之下,严重肝脏病变患者和对照组中这些抗原的数量相似。另一方面,在酒精性患者与对照组之间,或两个酒精性组之间,未观察到II类HLA抗原患病率的差异。这些数据表明,携带A30、B16和Bw56抗原的酒精性患者发生严重肝病的易感性较低。