重型丙型肝炎患者肝外脏器病毒感染和复制状态  

Extrahepatic infection and replication of hepatitis C virus in patients with severe hepatitis C

作　　者：严福明[1] 郝飞[2] 陈安慎[1] 顾长海[2] 赵西平[3] 赵利斌[1] 杨东亮[3] 郝连杰[3] 

机构地区：[1]解放军第161中心医院感染科,武汉430010 [2]第三军医大学西南医院全军传染病专科中心 [3]同济医科大学同济医院临床免疫研究室

出　　处：《中华传染病杂志》2001年第5期300-303,T007,共5页Chinese Journal of Infectious Diseases

基　　金：全军医药卫生科研基金资助项目 (98D0 66)

摘　　要：目的　探讨丙型肝炎患者肝外脏器丙型肝炎病毒 (HCV)感染和复制状态。方法　采用逆转录 聚合酶链反应 (RT PCR)、原位杂交 (ISH)和免疫组织化学法 ,对 9例重型丙型肝炎患者肝外 8种脏器内HCV基因、HCV复制中间体和HCV抗原表达进行了研究。结果　采用RT PCR ,9例患者肝外脏器均可检出HCV基因 ,6例 (6 6 .7% )检出HCV复制中间体及HCV抗原 ;采用ISH和免疫组化法 ,5例 (5 5 .6 % )检出HCV基因。除脾脏外 ,心脏、肾脏、胰腺、肾上腺、肠道、胆囊和淋巴结等脏器细胞内有HCV基因和HCV抗原表达。结论　肝外多种脏器细胞可能支持HCV复制 ;肝外HCV感染程度轻 。Objective TostudytheextrahepaticinfectionandreplicationofhepatitisCvirusinthe patientswithhepatitisC .Methods HCVRNA ,intermediateofHCVreplication(minus strandofHCV RNA) ,andHCVantigensweredetectedbyreverse transcriptasepolymerasechainreaction(RT PCR) ,in situhybridization(ISH)andimmunohistochemistryin 38autopsyextrahepatictissuespecimens(including kidney ,heart,pancreas ,intestine ,adrenalgland ,spleen ,lymphnode,andgallbladder)from 9hepatitisC patients.Results ByRT PCR ,all 9patientswerepositiveforHCVRNAinkidney ,heart ,pancreas , andintestine .However,only 6 (6 6 .7% ) patientswerepositiveforintermediateofHCVreplication .The positiveratesofHCVRNAandHCVantigensinextrahepaticorgansotherthanspleenwere 5 5 .6 % (5 pa tients)and 6 6 .7% (6 patients)respectively .HCVRNAandHCVantigenswerepositiveinthefollowing cells:myocardialcells,epithelialcellsofintestine ,interstitialcellsofkidney ,epithelialcellsoftubulesand glomerulus ,pancreasacinarcellsandepithelialcellsofpancreaticduct,epithelialcellsofmucousmembrane sinusofgallbladder ,cortexandmedullacellsinadrenalgland ,andmononuclearcellsinlymphnode .Con clusion TheseresultsshowthatHCVreplicationexistsinvariousextraheptictissuecellsatlow level, whichmayhavecertainpathogeneticandclinicalsignificanceinthepatientswithHCVinfection .

关 键 词：丙型肝炎病毒 免疫组织化学 原位杂交 病毒复制 HCV-RNA 丙型肝炎 

分 类 号：R512.63[医药卫生—内科学]