中文摘要：

目的 评价血浆抗可溶性肝抗原抗体（抗SLA）检测在乙型肝炎病毒（HBV）相关慢加急肝衰竭（HA）患者中的意义。方法 使用抗SLA酶联免疫检测试剂盒,检测H-A患者（H-A组）、肝硬化（LC）患者（LC组）、慢性乙型肝炎（CHB）患者（CHB组）和健康对照者（HC组）血浆抗SLA,分析不同临床组间抗SLA的表达差异,以及与肝功能相关指标的关系。结果 慢性HBV感染（CHB＋LC＋H-A）组的抗SLA水平均显著高于HC组（P〈0.001）,而H-A组抗SLA的OD值显著高于CHB组（P〈0.001）、LC组（P〈0.001）;在HBV感染者中,抗SLA的OD值水平与ALT（r=0.260,P=0.046）及TBIL（r=0.646,P〈0.001）水平呈正相关,与HBV-DNA无明显相关性（r=-0.069,P=0.598）。在H-A组,抗SLA的OD值水平与总胆汁酸呈正相关（r=0.478,P=0.024）,与凝血酶原活动度、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、直接胆红素（DBIL）、总胆红素（TBIL）无显著相关性。结论 这种检测方法可用于评估不同慢性HBV感染者抗SLA的表达差异,H-A患者高表达抗SLA可能与肝细胞的严重损伤及免疫发病机制相关。

英文摘要：

Objective To evaluate the significance of serum anti -SLA level in patients with HBV -related acute - on - chronic liver failure （ H - A）. Methods A total of 26 patients with H - A （ H - A group）, 16 patients with chronic hepatitis B （CHB group） , 17 patients with liver cirrhosis （LC group） and 14 healthy controls were enrolled （HC group）. The serum level of anti - SLA was detected by enzyme linked immunosorbent assay. Results The optical density value level of anti - SLA in patients with HBV infection was significantly higher than that of HC group （P 〈 0. 001 ）. Moreover, the level of anti - SLA in H - A group was significantly higher than those in CHB group （P 〈0. 001 ） and LC group （P 〈 O. 001 ）. The level of anti - SLA was positively correlated with ALT （r =0. 260, P =0. 046） and TBIL （r =0. 646, P 〈 0. 001 ）, hut not correlated with HBV - DNA （r = -0. 069, P =0. 598） in patients with HBV infection. In H - A group, the level of anti -SLA was positively correlated with total bile acid （r = 0. 478, P = O. 024）, but not correlated with pro- thrombin activity （PTA）, ALT, AST, DBIL or TBIL. Conclusion It is suggested that the difference of anti - SLA ex- pression among the patients with HBV infection could be assessed using this method, and the high level of anti - SLA in H - A patients might be correlated with the progression and prognosis of acute - on - chronic liver failure.