用人工合成的丁型肝炎病毒抗原多肽检测丁肝病毒IgM抗体及其初步应用

DETECTION OF IgM ANTIBODY TO HDV BY USING SYNTHETIC PEPTIDE OF HDV ANTIGEN

用人工合成的丁型肝炎病毒抗原（ＨＤＶ－Ａｇ）肽建立了检测抗ＨＤＶ－ＩｇＭ抗体的ＥＬＩＳＡ方法，本法操作简便、快速，重复性好，特异性强，与抗ＨＡＶ－ＩｇＭ、抗Ｈｋ－ＩｇＭ、抗ＨＢｓ－ＩｇＭ、抗ＨＣＶ－ＩｇＩ、抗ＣＭＶ－ＩｇＭ、抗ＲＶ－ＩｇＭ、类风湿因子（ＲＦ）及抗核抗体（ＡＮＡ）阳性血清均不起反应，且可被２－巯基乙醇阻断而不起反应。经初步临床应用，３１例正常人血清抗ＨＤＶ－ＩｇＭ全部阴性，２８例慢活肝患者检出率为３２．１％（９／２８），１７例慢迁肝患者血清阳性率为１１．８％（２／１７）１８例肝癌和肝硬化病人血清阳性率为２２．２％（４／１８）这三组病人与正常对照者相比较均有显著性差异（Ｐ＜０．００１）。此外，抗ＨＤＶ－ＩｇＭ阳性血清的ＡＬＴ值均明显高于正常参考范围，提示在ＨＤＶ感染过程中，患者肝细胞进一步受损。实验结果证明，抗ＨＤＶ－ＩｇＭ是诊断ＨＤＶ感染的重要指标，对ＨＤＶ感染早期诊断具有重要价值。

In this study,an HDV-IgM antibody detection assay (ELISA) was described by usingsynthetic peptide of HDV antigen, The assay was easy,rapid, reproducible and specific.Nocross-reaction was detected with IgM for hepatitis A,B(HBs,HBc),C and CMV ,RV(A),ANA,nor was there any interference by rheumatoid-factor.The results for sera of 31 normalpersons were all negative. But anti-HDV IgM was detected in 9 of 28 patients(9/28, 32.1%)with CAH, in 2 of 17 patients(2/17,11.8%) with CPH and in 4 of 18 patients(4/18, 22.2%)with liver cancer and cirrhosis(P<0.001).The ALT levels of the anti-HDV IgM positive serawere higher than those of negative sera, It is suggested that hepatic cells were injured while in-fected by HDV. These results demonstrated that identification of anti-HDV IgM is ofconsiderable significance in the early diagnosis and management of HDV infection.