抗HBc IgM阳性慢性乙型肝炎临床特性、病毒学和血清学研究  

Virological, serological and clinical characteristics of anti-HBc IgM positive chronic hepatitis B patients

作　　者：张春泽 田志新 石栓柱 李明慧[2] 谢尧[2] 

机构地区：[1]张家口市传染病医院感染科,河北省075000 [2]北京地坛医院肝炎一科

出　　处：《中华实验和临床病毒学杂志》2007年第2期138-140,共3页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的探讨抗HBcAg IgM阳性慢性阳性肝炎患者的临床特性及其与HBV病毒学和血清学的关系。方法收集河北省张家口市传染病医院和北京地坛医院2004--2006年经Abbott EIA检测试剂证实的所有抗HBcAg IgM阳性和同期随机抽样的抗HBcAg IgM阴性患者的临床资料，包括生化指标、血清HBVDNA载量和血清学指标，分析抗HBcAg IgM阳性和阴性患者的疾病程度和临床转归之间的差异及抗HBcAg IgM状态与HBV DNA载量和HBeAg状态的关系。结果收集了200例慢性乙型肝炎患者，其中抗HBc IgM阳性70例，阴性130例，轻、中和重度肝脏疾病患者分别为71、83、46例。抗HBc IgM阳性患者的年龄和发病年数高于抗HBc IgM阴性患者，抗HBc IgM阳性的轻度肝脏疾病患者百分比为45．71％，中重度患者为54．29％，低于抗HBc IgM阴性患者（30．00％和70．00％），差异有统计学意义（X^2=4．907，P=0．027）。抗HBc IgM阳性患者和阴性患者的HBV DNA载量，血清HBeAg/抗HBe状态、住院天数和转归差异无统计学意义。结论慢性乙型肝炎患者抗HBcAg IgM的状态与肝脏疾病的程度相关，但与HBV DNA载量和HBeAg／抗HBe状态无相关性。Objective To investigate the clinical characteristics of anti-HBc IgM positive chronic hepatitis B patients and the relation of anti-HBc IgM development to serum HBV DNA load and the state of HBeAg/anti- HBc. Methods The clinical data were collected from patients with chronic hepatitis B hospitalized in the Infectious Diseases Hospital, Zhangjiakou city, and in Ditan Hospital, some of whom were anti-HBc IgM positive and some others were negative. Their HBV DNA load was examined by real-time PCR, and HBeAg/anti-HBe was detected by AXSYM auto-enzyme analyzer with the third generation EIA regent. Results Totally 200 patients were enrolled in this study. The number of patients with mild, moderate and severe hepatitis was 71, 83 and 46. The anti-HBc IgM positive patients were older and had longer course of disease than those of anti-HBc IgM negative patients. Of the anti-HBc IgM positive group, 45.71% and 54.29 % had mild and moderate hepatitis, which were significantly different from those in the anti-HBc IgM negative patients （30.00% and 70.00% ） . But there was no difference between anti-HBc IgM positive and negative patients in serum HBV DNA level, the state of HBeAg/anti-HBe and outcome. Conclusion The anti-HBc IgM state of chronic hepatitis B patients was related to the severity of hepatitis, but not with virus load and state of HBeAg/anti-HBe.

关 键 词：肝炎 乙型 慢性 肝炎病毒 乙型 DNA 肝炎e抗原 乙型 肝炎核心抗原  乙型 免疫球蛋白M 

分 类 号：R686[医药卫生—骨科学]