The Change Of SIgA In Gastric Mucus And Its Significance Among Patients With Chronic HBV Infection That Combined With Gastric Mucosal Lesion

Objective:To investigate the effect of sIgA in gastric mucus on gastric mucosal lesion among patients with chronic HBV infection by detecting the level of sIgA in gastric mucus. Methods:①Experiments were set up in three groups:the experimental group was that the patients with chronic HBV infection, including 13 cases of chronic hepatitis B,14 cases of active hepatitis B cirrhosis,13 cases of chronic severe hepatitis B; The group of the patients with chronic gastritis was the 40 cases of chronic gastritis, excluding previous history of liver disease; The control group was 9 cases of people with normal gastric mucosa and liver function.②All patients should do electronic gastroscopy before treatment, then the gastric and duodenal mucosal lesions were observed from the morphology. During doing electronic gastroscopy, gastric mucus was taken as specimen. Meanwhile, the venous blood of people among experimental group and control group should be collected. The level of sIgA was detected by radioimmunoassay. Results:①By Me Cormick standards, the gastric mucosal lesion in the experimental group accounted for 80% (32/40), even the rate of severe gastric mucosal lesion in the patients with chronic HBV infection was 46.15% (6/13); The incidence of the gastric mucosal lesion in patients with chronic gastritis accounted for 77.5% (31/40).②The difference of the level of sIgA in gastric mucus between the experimental group and the control group was statistically significant (F=6.655, P< 0.01), the level of sIgA in gastric mucus among the chronic hepatitis B, liver cirrhosis group was higher than the normal group (P<0.01, P<0.05). Accompany the chronic liver disease becoming severe, the level of sIgA gradually decreased. It was lowest in severe chronic hepatitis, which compared with the chronic hepatitis B, liver cirrhosis group has statistical difference(all P<0.01). With the gastric mucosal lesion being more severe, the level of sIgA in gastric mucus was gradually decreased. It in the group of severe gastric mucosal lesion in the patients with chronic HBV infection has obviously decreased, which compared with the group that 0 degrees, mild gastric mucosal lesion had statistically significant difference (P<0.01, P<0.05). The difference between 0 degree and moderate degree gastric mucosal lesions groups was statistically significant (P<0.05). The level of sIgA in gastric mucus was negatively correlated with the degree of gastric mucosal lesion in chronic liver disease (r=-0.516, P<0.01).③The level of sIgA in gastric mucus was correlated with ALB and PTA (P<0.01), however, it had no correlation with ALT and TBIL (P>0.05).④It had not statistical difference that the sIgA level of chronic gastritis between different gastric mucosal lesion (F=1.706, P>0.05). The group of severe gastric mucosal lesions had highest level of sIgA.⑤The level of serum sIgA in chronic HBV infection was higher than normal control group (F= 6.382, P<0.01), but it has not statistically difference between the levels of serum sIgA in different liver disease groups (P＞0.05).Conclusion:Patients with chronic HBV infection often concide with gastric mucosal lesions. Accompany more severe injury of liver, the incidence of gastric lesions is higher and the damage of gastric mucosa is more severe. There are lots of factors that relate to the gastric mucosal lesion, and deficiency of sIgA in gastric mucus which is the important factor in gastric mucosal defense may involve in the formation of gastric mucosal lesions in chronic HBV infection.