摘要
采用合成肽酶免疫分析法（ｓｐＥＬＩＳＡ）和美国Ｏｒｔｈｏ公司第２代ＥＬＩＳＡ（２ｎｄＥＬＩｓＡ）对１０３例重型肝炎患者血清丙型肝炎病毒抗体（抗ＨＣＶ）作筛选，阳性血清用重组免疫印迹法（４·ＲＩＢＡ）作鉴定，并用逆转录聚合酶链反应检测ＨＣＶＲＮＡ，以重新评价重型肝炎患者血清抗ＨＣＶ存在状态及其意义。发现ｓｐＥＬＩＳＡ和２ｎｄＥＬＩＳＡ检测抗ＨＣＶ的阳性率分别为２２．３３％（２３／１０３）和１９．１０％（１７／８９），阳性血清经４·ＲＩＢＡ鉴定仅５９．０９％（１３／２２）阳性，ＨＣＶＲＮＡ检出率亦仅为６０．００％（９／１５）。动态观察，约１／３抗ＨＣＶ阳性患者抗ＨＣＶ持续２～４周消失。血清反复冻融可使阳性检测吸光值（Ａ４９２）下降，阴性检测Ａ４９２值升高。血清抗ＨＣＶ阳性和（或）ＨＣＶＲＮＡ阳性患者均合并乙型肝炎病毒（ＨＢＶ）感染，但合并ＨＣＶＲＮＡ阳性患者预后较差。结果提示单独ＨＣＶ感染不是本地区重型肝炎发生的主要原因，部分患者抗ＨＣＶ存在可能属既往感染或系“被动输入”所致，也可能为假阳性，检测ＨＣＶＲＮＡ对于确切了解重肝患者ＨＣＶ感染状况和判断预后有一定的意义。
he study
was designed to reevaluate the prevalence and significance of
antibody to hepatitis C virus(antiHCV)in sera from patients with
severe viral hepatitis. 103 cases of patients with severe viral
hepatitis werescreened for anti-HCV using ELISA based on synthetic
peptides(spELISA )and second generation ELISA(2nd ELISA), then the
sera positive with anti HCV were identified by second generation
recombinant im-munodot assay(4· RIBA),and tested by reverse
transcription-polymerase chain reaction(RT-PCR)for HCVRNA. Positive
rates of anti-HCV detected by spELISA and 2nd ELISA were
22.22%(23/103)and 19. 10%(17/89) respective. Among these sera only
59.09%(13/22) were shown to be positive by 4·RIBA. After 2-4
weeks,in about one third of patients anti-HCV became negative. All
the patients with postive anti-HCVand/or positive HCV RNA were
coinfected with hepatitis B virus,but the patients with positive HCV
RNAshowed poor prognosis. These results suggested that HCV infection
alone seems not to be the major cause ofsevere viral hepatitis. In
some patients anti-HCV may related to post-infection of HCV,“passive
transfer”ofanti-HCV or false detective positive. So it is valuable
to detect HCV RNA for confirming the prevalence of HCV infection.
出处
《肝脏病杂志》
CSCD
1994年第4期213-215,共3页
