罗文燕 金玉梁

[摘要] 目的 分析免疫球蛋白（Ig）检验对乙型肝炎患者治疗的临床应用价值。 方法 选取2019年1月至2020年3月间南昌市洪都中医院收治的64例乙型肝炎患者作为研究对象，按病情严重程度将其分为轻型组（n=36）和重型组（n=28）;另外选择同期在南昌市洪都中医院进行健康体检的20例健康者作为对照组，三组均给予免疫球蛋白检验，比较三组的血清IgA、IgM、IgG水平。与此同时，跟踪64例乙型肝炎患者的具体治疗情况，根据病情改善分为改善组（n=41）和未改善组（n=23），再对比两组的血清IgA、IgM、IgG以及总胆红素水平。 结果 经检验，重型组的血清IgA、IgM、IgG水平高于轻型组、对照组（P<0.05）;轻型组的血清IgA、IgM、IgG水平高于对照组（P<0.05）。经跟踪、总结，64例乙型肝炎患者中有41例治疗后病情得到顯著改善（改善组），23例治疗后未见明显有好转迹象（未改善组），改善组的血清IgA、IgM、IgG及总胆红素水平均低于未改善组（P<0.05）。 结论 通过血清IgA、IgM、IgG水平的检测，能有效判断乙型肝炎的病情严重程度，也能作为疾病诊断的重要标志物之一，再结合总胆红素水平，可判定疾病治疗效果，免疫球蛋白检验价值高。

[关键词] 免疫球蛋白;IgA;IgM;IgG;乙型肝炎;总胆红素

[Abstract] Objective To analyze the clinical value of immunoglobulin（Ig） test in the treatment of hepatitis B patients. Methods A total of 64 patients with hepatitis B admitted to Nanchang Hongdu Hospital of TCM from January 2019 to March 2020 were selected as the research subjects. They were divided into the light group（n=36） and the severe group（n=28） according to the severity of the disease. In addition， 20 healthy people who underwent physical examination in Nanchang Hongdu Hospital of TCM were selected as the control group during the same period. All three groups were given an immunoglobulin test. The serum IgA， IgM， and IgG levels of the three groups were compared. At the same time， the specific treatment of 64 patients with hepatitis B was followed up. They were divided into the improved group（n=41） and the unimproved group（n=23） according to their improvement. Then the serum IgA， IgM， IgG， and total bilirubin levels of the two groups were compared. Results After the test， the levels of serum IgA， IgM， and IgG in the severe group were higher than those in the light group and the control group（P<0.05）. The levels of serum IgA， IgM， and IgG in the light group were higher than those in the control group（P<0.05）. After follow-up and summary， 41 out of 64 patients with hepatitis B were significantly improved after treatment（improvement group）; 23 cases showed no apparent signs of improvement after treatment（unimproved group）. The serum IgA， IgM， IgG， and total bilirubin levels in the improved group were lower than those in the unimproved group（P<0.05）. Conclusion The detection of serum IgA， IgM， and IgG levels can effectively determine the severity of hepatitis B and can also be used as one of the important markers of disease diagnosis. Combined with the total bilirubin level， it can determine the therapeutic effect of the disease. The immunoglobulin test is of high value.

[Key words] Immunoglobulin; IgA; IgM; IgG; Hepatitis B; Total bilirubin

乙型肝炎主要是由乙肝病毒感染所致，患者会出现黄疸、发热、呕吐、身体乏力、厌油等临床表现，该病严重可引发肝硬化，甚至肝癌，威胁患者的生命健康[1]。同时，乙型肝炎有一定的传染性，少数患者会成为无症状病毒携带者，因此，临床非常重视该病的预防、诊断、治疗、病情控制。免疫球蛋白（Ig）属于人体一种非常重要的免疫分子，能有效结合特定的抗原，且具有一定的特异性，以此来抑制病毒靶细胞、中和毒素、阻止细菌黏附在宿主的细胞上，并调节机体免疫力及介导超敏反应等，对人体有重要作用[2]。但若人体肝脏出现问题后，机体免疫系统发生障碍，血清免疫球蛋白会随之改变，导致血清IgA、IgM、IgG等水平升高[3]。有相关研究指出[4]，免疫球蛋白在肝脏损伤过程中扮演着重要角色，通过血清IgA、IgM、IgG水平的检验，能为乙型肝炎诊断提供有力依据，在乙型肝炎治疗中也有重要指导意义。……