mimmunМедицинская иммунологияMedical Immunology (Russia)1563-06252313-741XSPb RAACI10.15789/1563-0625-2007-6-575-580mimmun-243Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESРАСПРОСТРАНЕННОСТЬ И ФАКТОРЫ РИСКА РАЗВИТИЯ КРИОГЛОБУЛИНЕМИИ, АССОЦИИРОВАННОЙ С ХРОНИЧЕСКИМ ГЕПАТИТОМ СPREVALENCE AND RISK FACTORS IN DEVELOPMENT OF CHRONIC HEPATITIS C-ASSOCIATED CRYOGLOBULINEMIAДунаеваН. В.DunaevaN. V.

197374, ул. Савушкина, 107, корп. 1, кв. 323. Тел.: (812) 344-85-97, 8-921-741-88-20 (моб.)

nvch@mail.ruНеустроеваЮ. А.NeustroevaYu. A.nvch@mail.ruТихомироваТ. А.TikhomirovaT. A.nvch@mail.ruСысоевК. А.SyssoevK. A.nvch@mail.ruАлексееваН. П.AlexeevaN. P.nvch@mail.ruЛапинС. В.LapinS. V.nvch@mail.ruЭсауленкоЕ. В.EsaulenkoE. V.nvch@mail.ruДобронравовВ. А.DobronravovV. A.nvch@mail.ruЧухловинА. Б.ChukhlovinA. B.nvch@mail.ruТотолянАрег А.TotolianAreg A.nvch@mail.ruСанкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова, Санкт-ПетербургRussian Federation20071707201496575580Copyright © Дунаева Н.В., Неустроева Ю.А., Тихомирова Т.А., Сысоев К.А., Алексеева Н.П., Лапин С.В., Эсауленко Е.В., Добронравов В.А., Чухловин А.Б., Тотолян А.А., 20142014Дунаева Н.В., Неустроева Ю.А., Тихомирова Т.А., Сысоев К.А., Алексеева Н.П., Лапин С.В., Эсауленко Е.В., Добронравов В.А., Чухловин А.Б., Тотолян А.А.Dunaeva N.V., Neustroeva Y.A., Tikhomirova T.A., Syssoev K.A., Alexeeva N.P., Lapin S.V., Esaulenko E.V., Dobronravov V.A., Chukhlovin A.B., Totolian A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mimmun.ru/mimmun/article/view/243

Резюме. Цель исследования: определить распространенность и факторы риска криоглобулинемии, ассоциированной с хроническим гепатитом С (ХГС) в Санкт-Петербурге. Пациенты и методы. Был обследован 121 пациент с ХГС (53 мужчины и 68 женщин, средний возраст 39±13 лет, медиана срока от момента инфицирования вирусом гепатита С (HCV) – 3 года (0,5-34 года), 25 (20,7%) пациентов имели цирроз печени). Результаты. У 37,2% (45/121) пациентов были обнаружены криоглобулины. В основном отмечались низкие уровни криокрита (1-4%). У пациентов с криоглобулинемией чаще выявляли ревматоидный фактор (p = 0,001), гипербиллирубинемию (p = 0,003) и повышение активности γ-глутамилтранспептидазы (p = 0,031). Наличие криоглобулинов не коррелировало с генотипом HCV. Частота генотипов HCV составила: 1a – 20,8% против 20,7%; 1b – 29,2% против 27,6%; 2 – 4,2% против 6,9%; 3a – 20,8% против 34,5%; микст – 20,8% против 6,9%, неопределенный – 4,1% против 3,4%, у криопозитивных и крионегативных пациентов, соответственно, p = 0,7. Независимыми предикторами развития криоглобулинемии явились длительность течения ХГС (Exp (B) = 1,07, 95% ДИ 1,0-1,13, p = 0,049) и наличие цирроза (Exp (B) = 6,2, 95% ДИ 2,25-16,8, р < 0,001). Заключение. Полученные данные указывают на высокую распространенность криоглобулинемии у пациентов с ХГС, ассоциирующуюся с длительным течением заболевания и развитием цирроза.

Abstract. The aim of the study was to assess prevalence and risk factors for cryoglobulinemia associated with chronic hepatitis C in St.-Petersburg. Patients and methods. We studied 121 patients with chronic hepatitis C, including 53 men and 68 women with median age of 39±13 years. The median hepatitis duration was 3 years (range 0.5 to 34 years). In this group 25 (20,7%) had cirrhosis. Results. 37,2% (45/121) patients had circulating cryoglobulins. A low levels of crioglobulins (cryocrit 1-4%) were detected more frequently. Cryoglobulinaemic patients showed more frequent rates rheumatoid factors activity (р = 0,001), a higher levels of bilirubin (р = 0,003) and a γ-gamma-glutamyltransferase (р = 0,031). The presence of cryoglobulins was not correlated with HCV genotype (HCV 1a – 20,8% vs 20,7%, 1b – 29,2% vs 27,6%, 2 – 4,2% vs 6,9%, 3a – 20,8 vs 34,5%, mixt – 20,8% vs 6,9%, not identified – 4,1% vs 3,4%, in cryopositive vs cryonegative patients respectively, р = 0,7). By multivariate analysis hepatitis duration (Exp (B) = 1,07, 95% Cl 1,0-1,13, р = 0,049) and cirrhosis (Exp (B) = 6,2, 95% Cl 2,25-16,8, р < 0,001) could independently predict the presence of cryoglobulins. Conclusion. Our study demonstrates high prevalence of serum cryoglobulins in patients with chronic hepatitis C in St.-Petersburg and independent association between duration of hepatitis and advanced cirrhosis with development of cryoglobulinemia.

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The authors declare that there are no conflicts of interest present.