散发性戊型肝炎病毒感染的诊断  

Diagnosis of hepatitis E virus infection in sporadic acute hepatitis

作　　者：江永珍[1,2] 毕胜利 李景源[1,2] 鲁健 廖胜东[1,2] 赵洪兰 王培之[1,2] 詹美云 刘崇柏 

机构地区：[1]中国预防医学科学院病毒学研究所 [2]北京市天坛医院北京市第一传染病医院

出　　处：《中华实验和临床病毒学杂志》1997年第2期177-180,共4页Chinese Journal of Experimental and Clinical Virology

摘　　要：用基因工程重组的戊型肝炎病毒（ＨＥＶ）基因结构区第二读码框架（ＯＲＦ２）和第三读码框架（ＯＲＦ３）具有免疫表位的嵌合抗原（ＯＲＦ３－２），建立了间接酶联免疫法（ＥＩＡ），检测散发性急性肝炎病人血清中抗－ＨＥＶＩｇＧ和ＩｇＭ抗体。在４６例急性肝炎病人中检出抗－ＨＥＶＩｇＧ抗体阳性７例，阳性率为１５．２２％，７例ＩｇＧ抗体阳性中，有５例ＩｇＭ抗体也阳性，占７１．４％（５／７）。１０２例排除了甲型、乙型和丙型肝炎病毒感染、怀疑为戊型肝炎的病人，检出抗－ＨＥＶＩｇＧ和ＩｇＭ抗体阳性率分别为９１．８％（９３例）和７６．４７％（７８例），约７５％（７３／９８例）的病人血清同时测到抗－ＨＥＶＩｇＧ和ＩｇＭ抗体，９８名正常人抗－ＨＥＶＩｇＧ抗体检测，有４名阳性，阳性率为４．０８％，未测到ＩｇＭ抗体。对单独抗－ＨＥＶＩｇＧ抗体阳性的病人经追踪观察，发现６例ＩｇＧ抗体有４～１６倍降低，１例有２倍升高。对单独ＨＥＶＩｇＭ抗体阳性病人的血清经检测类风湿因子均阴性，血清用ＨＥＶ抗原特异性阻断和２－巯基乙醇破坏，证明为ＨＥＶ特异性ＩｇＭ抗体。本文采用基因工程重组的戊型肝炎病毒ＯＲＦ３－２嵌合抗原建立的ＥＩＡ法同时检测散发性急性肝炎病人?The solid-phase enzyme immunoassay (EIA) was used for detecting anti-HEV immunoglobulin G (IgG) and M (IgM) by using a recombinant chimeric antigen (ORF3-2) from the open reading frame (ORF) 2 and 3 of hepatitis E virus gene. These sera were collected from the patients with sporadic acute viral hepatitis. The positive rate for anti-HEV IgG was 15.22% (7) among 46 patients with acute hepatitis, 5 of the 7 IgG positive sera were also positive (71.4%) for anti-HEV IgM. 91.8% (93) and 76.4% (78) were positive separately for anti-HEV IgG and IgM among 102 patients of suspected HEV infection (these patients were negative for anti-HAV, anti-HBV and anti-HCV), about 2/3 patients of HEV infection detected were simultaneously HEV-IgG and IgM positive. In control group of 98 normal persons, 4 (4.08%) were positive for anti-HEV IgG, but none were IgM positive. Paired sera of the patients in the acute phase and convalescent phase were detected, the titers of anti-HEV IgG with 4-16 fold decrease were seen in 6 cases and with 2-fold rise in 1 case.

关 键 词：戊型肝炎病毒 病毒抗原 IgGIgM 诊断 

分 类 号：R512.63[医药卫生—内科学]