急性肝炎恢复期血清检测抗戊型肝炎病毒抗体及RNA的临床诊断意义  

Clinical significance of detecting RNA and anti HEV antibody in convalesent sera in patients with acute HEV hepatitis

作　　者：李卓[1] 郝娃[1] 蓝海云[2] 辜文洁[2] 王佑春[2] 

机构地区：[1]北京佑安医院肝炎研究所,100054 [2]中国药品生物制品检定所细胞室

出　　处：《中华实验和临床病毒学杂志》2004年第3期268-271,共4页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的　在急性非甲 戊型肝炎患者中进一步追踪检测不同时期血清抗戊型肝炎病毒(HEV)IgG ,以明确临床诊断。方法　用美国Genelabs公司和北京万泰公司抗HEV诊断试剂检测抗HEV ,用PCR方法检测HEVRNA ,并进行基因序列分析。结果　 95例入院首次血清学诊断为急性非甲 戊型肝炎患者中 ,在住院后 11～ 2 5d、2 5～ 35d分别测定血清抗HEV ,16例血清抗HEV阳性 (万泰公司 ) ,急性期血清HEVRNA检测 10例HEVRNA阳性 ,经核苷酸序列分析证明 ,其中 4例为Ⅰ型HEV感染 ,6例为Ⅳ型HEV感染。Genelabs诊断试剂检测 12例抗HEV阳性 ,7例HEVRNA阳性 ,其中4例是HEVⅠ型病毒感染 ,3例是HEVⅣ病毒感染。结论　对非甲 戊型肝炎患者进行急性期HEVRNA检测和恢复期抗HEV检测可以进一步明确病原学诊断 ,在这部分患者中存在HEV不同基因型感染 ,可能是HEV感染漏诊的原因之一。Objective To investigate the anti hepatitis E virus (HEV) and HEV RNA in acute and convalesent sera of patients with NonA-E acute hepatitis Methods The serum samples were taken from 95 patients who were diagnosed as acute NonA-E hepatitis Enzyme immunoassay (EIA) was used for detecting anti-HEV Immunoglobulin G (IgG,Genolable and Wantai EIA anti-HEV kits)RT-PCR amplification of HEV RNA was based on the open reading frame 2 region of HEV and the PCR products were sequenced Results Sera from 95 patients who were negative for anti-HEV in acute phase were followed up for 11-35 days to detect the anti-HEV antibody in recovery phase, 16/95(1684%)were positive for anti-HEV(wantai EIA anti-HEV kits)Ten (6250%)were positive for HEV RNA in acute phaseSequence analysis showed that 4 were HEV genotype Ⅰ 6 were HEV genotype Ⅳ;12/95 (1250%)were positive for anti-HEV (Genolable EIA anti-HEV kits)Seven were positive for HEV RNA;4 belonged to HEV genotype Ⅰ,3 were HEV genotype Ⅳ Conclusion It is significant and necessary to detect anti HEV antibody and HEV RNA in patients with HEV infection during acute phase and convalesent phase.

关 键 词：HEV感染 阳性 患者 血清 非甲-戊型肝炎 戊型肝炎病毒 恢复期 毒感染 基因型 诊断试剂 

分 类 号：R512.63[医药卫生—内科学]