单纯GBV-C/HGV感染人体血清学和病理学追踪研究  

Serological and pathological follow-up studies of the patients with single GBV C/HGV RNA infection

作　　者：赵景民[1] 王松山[1] 辛少杰[1] 程云[1] 于建国[2] 刘平[1] 貌盼勇[1] 毛远丽[1] 马玉芝 陈菊梅[1] 

机构地区：[1]解放军第三O二医院,100039 [2]解放军第八十八医院传染病科 [3]吉林石化总医院传染病科

出　　处：《中华实验和临床病毒学杂志》2001年第1期16-19,共4页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的　从临床和病理学方面探讨庚型肝炎病毒 (GBV C/HGV)的致病性。方法　收集2 4例单纯血清GBV C/HGVRNA阳性人体的穿刺活检肝组织及血清标本 ,其中 8例作间隔 2年以上的二次肝穿 ,进行血清和肝组织GBV C/HGVRNA、血清抗E2抗体及ALT水平、肝组织NS3和NS5抗原检测 ,并作肝组织光、电镜观察。结果　 2 4例血清GBV C/HGVRNA阳性者首次肝穿前 3d内平均ALT水平为 6 0 .17IU/ml(4 2～ 87IU/ml) ,抗E2抗体阳性率 4 17% ,首次肝组织GBV C/HGVRNA阳性率为 75 0 0 % ,NS3和 (或 )NS5抗原阳性率为 5 4 17%。GBV C/HGVRNA及NS3和NS5抗原主要于肝细胞胞质内检出 ,阳性细胞呈散在分布 ,少数浸润的单个核细胞内有病毒RNA检出。肝细胞呈极轻度急、慢性炎症病变者占 79 17%。与 2年前比较 ,2年后 2 4例观测对象血清GBV C/HGVRNA自然转阴率 6 6 6 7% (P <0 0 0 1) ,血清ALT复常率 75 0 0 % (P <0 0 0 1) ,E2抗体阳性率为 41 6 7% (P <0 0 0 1) ,8例二次穿刺肝组织除 2例有灶状肝细胞水样变性外 ,余均复常。结论　庚型肝炎病毒可引起极轻度自限性肝炎 ,提示其致肝损伤作用微弱且具自限性 ;血清E2抗体是GBV C/HGV感染恢复性标志 。Objective To elucidate the pathogenicity of GBV C/HGV in causing viral hepatitis.Methods The sera and bioptic liver tissues,which involved 8 cases of the second liver puncture with an interval of 2 years,from 24 cases of single GBV C/HGV RNA positive patients were observed for more than 2 years.GBV C/HGV RNA in the sera and liver tissues was detected by using RT\|PCR and \%in situ\% hybridization,respectively.Under light and electron microscope,the pathology of the liver tissues was observed.Results At the beginning of the observation,the mean serum alanine transaminase(ALT) level was 60\^17 IU/ml (range,42\^00～ 87\^00 IU/ml ),and the positive rates of anti E2 antibody and GBV C/HGV RNA in the sera and NS3 and/or NS5 in the liver tissues were 4\^17%,75\^00% and 54\^17%,respectively.In all the examined specimens,79\^17% of them showed mild acute or chronic hepatitis,mainly presenting with degeneration of hepatocytes,mild portal inflammation.GBV C/HGV RNA and its NS3 and/or NS5 antigens were mainly detected in hepatocytes and a few mononuclear cells.In contrast,after more than 2 years,the natural change rate (negative rate of GBV C/HGV) of 24 cases was 66\^67% ( P <0 001).75\^00% had normal ALT level ( P <0 001) and 41\^67% of anti E2 antibody in the patients was positive ( P <0 001).Through histological observation,besides 2 cases of liver tissues showing very mild hydropic degeneration,there were no abnormal findings in 8 cases of the second liver biopsy. Conclusion GBV C/HGV could induce mild and self\|limited hepatitis,which showed that GBV C/HGV may be a light and self\|limited pathogenic agent to human liver.E2 antibody appearance may indicate a recovery and provide a protection from GBV C/HGV infection.Whether there is any other recovery marker in serum requires further study.

关 键 词：GBV-C/HGV 人类 血清学 病理学 自限性肝炎 病毒性肝炎 

分 类 号：R364[医药卫生—病理学]