不明原因肝病患者肝组织HBV及HCV抗原的检测及临床和病理特点  

Clinical and pathological characteristics of immunohistochemistry staining for HBV and HCV antigen on liver tissue of unknown etiology

作　　者：李炜[1] 王霞[2] 王琰[2] 朱新宇[1] 王守义[1] 陈常云[3] 

机构地区：[1]山西医科大学第一临床医院,太原市030001 [2]太原市传染病医院 [3]山东日照市中医医院

出　　处：《中华实验和临床感染病杂志（电子版）》2009年第4期5-8,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：山西省教育委员会科研基金(2008831)

摘　　要：目的了解不明原因肝病患者中HBV及HCV隐匿性感染所占的比例及临床、病理特点。方法对31例不明原因肝病患者,采用酶联免疫吸附试验(ELISA)检测血清乙型肝炎病毒标志物(HBV-M)(HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc)及丙型肝炎病毒抗体;血清HBV DNA采用荧光定量PCR法检测,HCV RNA采用RT-PCR法检测;应用免疫组织化学二步法检测肝组织中的HBsAg、HBcAg、HCV抗原,并进行常规病理检查。结果肝组织HBV抗原阳性者11例(35.5%);HBV、HCV抗原均阳性者10例(32.3%),全阴性者10例(32.3%)。存在HBV隐匿性感染的21例患者中,慢性肝炎患者7例,肝硬化患者12例,肝细胞性肝癌患者2例。结论HBV、HCV感染为不明原因肝病的主要原因,尤其是HBV感染。HBV隐匿性感染与慢性肝炎、肝硬化、肝癌关系密切,应引起重视。Objective To investigate the incidence of occult hepatitis B virus infection among chronic liver diseases of unknown etiology. Methods The serum HBV markers （ HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc） and anti-HCV were detected by ELISA. Serum HBV DNA was detected by FQ-PCR, HCV RNA with RT-PCR and HBsAg, HBcAg, HCV antigen in liver tissue with immunohistochemistry and some routine pathological examination were carried out. Results In 31 patients, 11 cases （35.5%） were positive with HBV antigen, 10 cases （32.3%） were positive with both HBV antigen and HCV antigen, also 10 cases （32.3%） were negative with both HBV antigen and HCV antigen. In 21 patients with occult HBV infection, 7 cases were chronic hepatitis, 12 cases were liver cirrohosis, 2 cases were hepatocellular carcino- ma. Conclusions Occult HBV and HCV infection may account for a high proportion in chronic liver diseases of unknown etiology, especially HBV infection. Occult HBV infection may induce liver cirrohosis and hepatocellular carcinoma, so more attentions should be paid to.

关 键 词：不明原因肝病 乙型肝炎病毒 丙型肝炎病毒 隐匿性感染 免疫组织化学 

分 类 号：R512.6[医药卫生—内科学] R446.6[医药卫生—临床医学]