乙型肝炎患者特异性CMSC及IIPC实验与临床研究

了解乙型肝炎患者补体介导 ＨＢｓＡｇ特异性免疫复合物溶解能力（ＣＭＳＣ）及补体介导免疫沉淀 的抑制作用（ＩＩＰＣ）两种新功能低下在乙型肝炎发病中的作用。方法：采用ＰＥＧ沉淀法测定患者血清循环免疫复 合物（ＣＩＣ），以ＨＢｓＡｇ和抗－ＨＢｓ制备特异性免疫复合物（ＩＣ），加入补体（血清）抑制其沉淀，或使ＩＣ裂解并定量测 定上清中的ＨＢｓＡｇ，确定ＣＭＳＣ及ＩＩＰＣ功能，同时用单向琼脂扩散法测定Ｃ３、Ｃ４。结果：患者组ＣＩＣ检出阳性率为 ４５．０％～８２．６％，均显著高于正常组（Ｐ＜０．０５～０．００１）；正常组ＣＭＳＣ后上清液ＨＢｓＡｇ为０．５８±０．１３ｎｇ，各种乙肝 组均明显低于正常对照组（Ｐ＜０．０５～０．００１）；ＩＩＰＣ后上清中ＨＢｓＡｇ浓度为０．４５±０．１８ｎｇ，急性肝炎、慢活肝、重症 肝炎均显著降低（Ｐ＜０．００１），肝硬化组亦明显降低（Ｐ＜０．０５）；Ｃ３、Ｃ４在患者组亦有不同程度的降低。结论：乙型 肝炎患者血清中存在特异性ＩＣ，患者ＣＭＳＣ及ＩＩＰＣ明显降低在乙型肝炎的发病中有一定作用，补体成分的减少与 ＣＭＳＣ和ＩＩＰＣ的降低有一定关系。

Experimental and clinical study on the specific CMSC and IIPC for cases with hepatitis B

Objective: To make sure the complement-mediated solibilizing capacity(CMSC) and inhibition of precipitation by complement (IIPC) in hepatitis B incidence. Methods: By using PEG precipitation method to determine serum circulating immune complex (CIC), HBsAg and anti-HBs were used to prepare spcific immune complex (IC), also add complement (serum) to solubilize and inhibit its precipitation, and quantitatively detect HBsAg in the supernatant, CMSC and IIPC function are defined, and meanwhile test C3, C4 by single agar diffusion method. Results: CIC positive the was 45.0%- 82.6% in the sufferers' group, being markably higher than that in the control group (P<0.05-0.001), HBsAg concentration in the supernatent of CMSC in the coned group was 0.58±0.13ng, the CMSC in the hepatitis groups all decreased significantly (P<0.05-0.001),the IIPC in the coned group was 0.45±0.18ng, acute hepatitis, chronic active hepatitis and severe hepatitis all decreased significantly (P<0.001), and in the hepatocirrhosis group was reduced as well, (P<0.05), C3, C4 had more or less decrease in the sufferers' group. Conclusion: Specific immune complex existed in the sera of the sufferers with hepatitis B. The CMSC and IIPC obvious decline in the sufferers played a certain role in the incidence of hepatitis B. The decline of complement composition and decrease of IIPC have some correlation.