戊型肝炎患者血清ORF2抗原的检测及临床意义  

Clinical significance of serum hepatitis E virus ORF2 antigen detection in hepatitis E patients

作　　者：耿彦生[1] 李红权[1] 张宏馨[1] 廉海晨[1] 李军[1] 周艳春[1] 耿坤静 

机构地区：[1]河北大学医学部,河北省保定市071000 [2]河北省保定市传染病院,河北省保定市071000

出　　处：《世界华人消化杂志》2013年第36期4153-4157,共5页World Chinese Journal of Digestology

基　　金：河北省科技计划基金资助项目;No.12277726;河北省自然科学基金资助项目;No.H2013201066~~

摘　　要：目的:研究戊型肝炎患者戊型肝炎病毒(hepatitis E virus,HEV)-Ag与其他检测指标的相关关系,评价HEV-Ag检测在临床诊断戊型肝炎中的意义.方法:116例急性戊型肝炎患者血清标本应用酶联免疫吸附试验试剂盒进行抗HEV IgM、抗HEV IgG和HEV-Ag检测,应用RT-NestedPCR进行HEV RNA检测.通过比较分析血清中HEV-Ag与HEV RNA检测结果,对HEV-Ag检测的临床意义进行评价.结果:诊断为戊型肝炎的116例患者初次采集的血清进行HEV感染标志物的检测,其中55.2%(64/116)为HEV-Ag阳性.116例患者中分别有5、21、63和27例为抗HEV IgMIgG-、IgM+IgG-、IgM+IgG+和IgM-IgG+,这4组中HEV-Ag的检出率分别为100%、90.5%、61.9%和3.7%.64例抗原阳性样本中40例(62.5%,40/64)为HEV RNA阳性,而52抗原阴性样本中只有1例(1.9%,1/52)为HEV RNA阴性,对HEV-Ag检测和HEV RNA检测的结果进行相关性分析,Kappa指数为0.582,显示血清中HEV-Ag检测和HEV RNA检测具有比较好的一致性.结论:HEV-Ag与HEV RNA的检测结果具有较好的一致性,HEV-Ag检测有助于戊型肝炎的早期诊断及慢性感染的诊断.AIM： To analyze the correlation of serum hepa- titis E virus （HEV） ORF2 antigen with other serum markers of HEV infection and assess the significance of HEV ORF2 antigen detection for the diagnosis of HEV infection. METHODS： Serum samples collected from sporadic hepatitis E patients were detected for anti-HEV IgM, anti-HEV IgG and HEV-Ag using ELISA kits. HEV RNA was detected by RT-Nested-PCR. The use of hepatitis E virus antigen as an early diagnostic marker for HEV infection was evaluated by comparing with HEV RNA detection. RESULTS： Among 116 samples collected for the first time after patient admission to the hos- pital, 5, 21, 63 and 27 were IgM-IgG-, IgM~ IgG-, IgM＋IgG＊ and IgMIgG~, respectively, and the HEV-Ag positive rate in each group was 100% （5/5）, 90.5% （19/21）, 61.9% （39/63） and 3.7% （1/27）, respectively. Out of the 64 HEV-Ag posi- tive samples, 40 （62.5%, 40/64） were HEV RNA positive; while out of the 52 HEV-Ag negative samples, only I （1.9%, 2/52） was HEV RNA pos- itive. The consistency between ELISA for ORF2 antigen detection and RT-PCR for HEV RNA was good （Kappa value -- 0.582）. CONCLUSION： The presence of HEV antigen is correlated with HEV RNA in serum samples of hepatitis E patients. HEV antigen detection is useful for the early diagnosis of acute hepatitis E.

关 键 词：戊型肝炎病毒 戊型肝炎 HEV ORF2蛋白 抗原检测 酶联免疫吸附试验 

分 类 号：R512.6[医药卫生—内科学]