乙型肝炎患者胃液与血清中乙型肝炎病毒、胃部病变及传播途径的关系  

Rrelationship between HBV in gastric juice, HBV in serum,stomach pathologic change,and route of transmission in hepatitis B patients

作　　者：陈安海[1] 赵逵[1] 刘模荣[1] 龙晓英[1] 王红[1] 周稻菽[1] 

机构地区：[1]贵州省遵义医学院附属医院消化内科,贵州遵义563003

出　　处：《临床荟萃》2003年第14期790-793,共4页Clinical Focus

摘　　要：目的　探讨乙型肝炎患者胃液乙肝病毒与胃部病变、血清乙型肝炎病毒 (HBV)指标及其传播途径的关系。方法　采用酶联免疫吸附试验 (ELISA)检测 5 8例慢性乙型肝炎患者及 18例血清HBV指标阴性的非乙型肝炎患者的胃液和血清中的HBV指标。用聚合酶链反应 (PCR)方法检测 5 8例中的 32例血清和胃液的HBV DNA。结果　 5 8例慢性乙型肝炎患者胃液中乙型肝炎e抗原 (HBeAg)和乙型肝炎表面抗原 (HBsAg)以及HBV DNA阳性患者其胃部病变较重 ,主要表现为隆起或平坦糜烂性胃炎、门脉高压性胃病、慢性胃炎伴胃窦急性炎症。胃液中HBeAg和HBsAg的阳性率在慢性乙型肝炎临床类型中的顺序依次为慢性乙型肝炎重度、乙型肝炎后肝硬化、慢性乙型肝炎中度 ,但HBeAg的阳性率在这 3种疾病中差异无统计学意义 (P >0 .0 16 7) ,而HBsAg的阳性率中慢性乙型肝炎重度明显高于慢性乙型肝炎中度 (P <0 .0 16 7)。 5 8例慢性乙型肝炎患者胃液中HBsAg、HBeAg及HBV DNA的检出率分别为 5 1.7%、12 .1%和 34.4 %。其胃液中的HBV指标与血清中的HBV指标无相关性 (P >0 .0 5 ) ,部分血清HBsAg、HBeAg及HBV DNA阴性者 ,胃液中出现阳性。结论　慢性乙型肝炎患者胃液中可检出HBV标志物 (HBVM )和HBV DNA ,具有传染性 ,且常伴有较明显的胃部病变 ,故应?Objective To investigate the relationships between HBV in gastric juice,HBV in serum,stomach pathologic change,and route of transmission.Methods HBV in gastric juice and in serum was detected in 58 cases of chronic hepatitis B and 18 cases of non hepatitis B but negative HBV revealed in serum by enzyme linked immunosorbent assay (ELISA). HBV DNA detection in gastric juice and serum was also performed by polymerase chain reaction(PCR) in 32 out of 58 cases of chronic hepatitis B.Results In 58 cases of chronic hepatitis B,stomach pathologic change was predominantly evident in these patients,whose HBeAg and HBsAg and HBV DNA in gastric juice showed positive results,and mainly showed: bulgy or level erosive gastritis,portal hypertension gastropathy(PHG),and chronic gastritis with sinus acute inflammation. In the clinical type of chronic hepatitis B the severe chronic hepatitis B was highest,than cirrhosis of liver,and lastly moderate chronic hepatitis B in the positive rate of HBeAg and HBsAg in the gastric juice but the differences of the three diseases were not statistically significant in the positive rate of HBeAg (P> 0.0167 ). However,severe chronic hepatitis B was obviously higher than moderate chronic hepatitis B in the positive rate of HBsAg (P< 0.0167 ). The positive rates for HBsAg,HBeAg and HBV DNA were respectively 51.7% , 12.1% and 34.4% in the gastric juice of 58 cases of chronic hepatitis B. No significant relationship was demonstrated between the HBV levels in gastric juice and serum (P> 0.05 ). HBV positive result in gastric juice was found in parts of patients with HBsAg,HBeAg and HBV DNA negative results in serum.Conclusion HBVM and HBV DNA were detected in gastric juice,making gastric juice have infections in these patients with chronic hepatitis B,and these patients often accompany obvious stomach pathological change. To prevent cross infection,it is essential to enhance device sterilization when gastroscopy is performed. HBVM and HBV DNA in serum were

关 键 词：肝炎 乙型 胃液 生物学标记 DNA 胃部病变 

分 类 号：R572.6[医药卫生—消化系统] R573[医药卫生—内科学]