摘要：目的  检测普通及合并白癜风的HBV感染者血清抗酪氨酸酶相关蛋白-1自身抗体（autoantibodies to tyrosinase-related protein-1,a-TRP-1）水平并分析其临床意义。方法  选取白癜风患者126例（其中合并HBV感染8例，合并a-TPO、a-TG阳性34例，其他白癜风病84例）；无白癜风病史的普通HBV感染者84例（HbsAg、HbeAg、HbcAb阳性24例，HbsAg、HbeAb、HbcAb阳性60例）；乙肝抗体阳性对照者96例(HbsAb、HbeAb、HbcAb阳性48例，HbsAb阳性48例)；乙肝五项全阴性的健康对照者96例。用ELISA法和细胞免疫荧光法检测所有标本a-TRP-1表达水平，并对结果进行统计分析。结果  白癜风组a-TRP-1总阳性率为6.3%（8/126），其中合并HBV感染者、合并a-TPO及a-TG阳性者、其他白癜风患者a-TRP-1浓度为分别为948.2±68.3 U/mL、36.1±0.1 U/mL 、54.3±12.8 U/mL ，各组阳性率分别为100%(8/8)、0%(0/34）、0%（0/84）；健康对照组为46.9±0.1 U/mL ，阳性率为0%（0/96）。白癜风组中合并HBV感染者与健康对照组抗体浓度比较，差异有统计学意义（P＜0.01），而a-TPO、a-TG阳性者、其他白癜风患者与健康对照组比较差异无统计学意义（P＞0.05）。普通HBV感染组中，HbsAg、HbeAg、HbcAb阳性者与HbsAg、HbeAb、HbcAb阳性者 a-TRP-1 浓度分别为868.7±161.4 U/mL 、756.7±157.5 U/mL ，阳性率分别为91.7%（22/24）、85.0%（51/60），与健康对照组比较,差异均有统计学意义（P＜0.01）；乙肝抗体阳性对照组中HbsAb、HbeAb、HbcAb阳性者与HbsAb阳性者分别为 26.8±0.1 U/mL 、33.3±0.1 U/mL ，阳性率分别为0%(0/48）、0%（0/48），与健康对照组比较，差异均无统计学意义（P＞0.05）。细胞免疫荧光法检测结果显示，ELISA法检测的a-TRP-1抗体阳性血清与黑素细胞培养固定物反应后，在胞浆和胞膜处发出明亮荧光，荧光强度+++～++++,合并a-TPO、a-TG阳性及部分其他白癜风患者血清在胞膜处也有荧光，荧光强度约++，健康对照血清荧光暗淡或无荧光。结论  a-TRP-1抗体的高表达与HBV感染有密切关系，该抗体应该不是大部分白癜风患者具有代表性的血清标志物，在大部分没有白癜风的普通HBV感染者体内也可高水平存在，这可能是该类患者继发白癜风的预兆和重要原因。

Objective To detect and explore the clinical significance of serum level of autoantibodies to tyrosinase-related protein 1 (a-TRP-1) in patients with HBV and vitiligo or with HBV only. Methods The serum a-TRP-1 were detected and analyzed by ELISA and immunofluorecence methods in 126 patients with vitiligo including 8 patients with HBV, 34 patients with a-TPO, a-TG positive and 84 other vitiligo patients; 84 common patients with HBV only including 24 patients with HbsAg, HbeAg and HbcAb positive, 60 patients with HbsAg, HbeAb and HbcAb positive; 96 people with antibodies to HBV positive including 48 subjects with HbsAb, HbeAb and HbcAb positive, 48 subjects with HbsAb positive and 96 healthy controls. Results The total positive rate of a-TRP-1 in all vitiligo patients was 6.3% only, and all the positive patients were infected with HBV. The serum levels of a-TRP-1 in vitiligo patients with HBV were significantly higher than those other vitiligo patients and healthy controls (P＜0.01). In common patients with HBV, the serum levels of a-TRP-1 were very similar to the vitiligo patients with HBV, but the positive rates of a-TRP-1 were much higher than those patients with vitiligo (P<0.01). The specificial autoantigens of a-TRP-1 in patients with HBV was located in the plasm and membrane of human melanocytes by immunofluoresence, while only located in membrane in most vitiligo patients. Conclusion The high level of a-TRP-1 has close relationship with the infection of HBV. It seems likely that TRP-1 may not be a representative targets of autoimmune response in vitiligo. The high positive rates of a-TRP-1 can be existed in the common patients with HBV, it may be a waring sign or play an important role in the pathogenic mechanisms of vitiligo in these patients.