丁型病毒性肝炎的原位分子杂交及免疫组化研究

An in situ hybridization and immunohistochemical study on hepatitis Delta

利用原位分子杂交和免疫组化方法对１４２例乙型肝炎活检肝组织进行丁型肝炎病毒ＲＮＡ及其抗原的定位研究。２８／１４２例丁型肝炎病毒标记阳性。其中慢性重症型６例；慢性活动性１７例；慢性持续性５例。慢性活动性乙肝重叠丁型肝炎病毒感染组发生早期肝硬变的比例明显高于无重叠感染组（Ｐ＜０．０５）。２８例丁型肝炎病毒感染肝组织１９例ＨＢｃＡｇ阳性，并以核浆型为主，提示活动性ＨＢＶ复制与ＨＤＶ感染的正相关性，两者相加作用导致肝损害加重并加速发展为肝纤维化。ＨＤＶＲＮＡ在肝细胞内大量蓄积，ＨＤＡｇ在碎屑状坏死边缘肝细胞或气球样变肝细胞内呈浆膜型分布，提示ＨＤＶ直接细胞毒在丁型肝炎发病学中的作用。

cases of biopsies of liver tissue were studied.HBsAg,HBcAg and HDAg were detected by ABC and direct immunoenzyme staining procedures.In situ hybridization was performed using digoxinlabeled HDV cDNA probes.HDV markers were found in 28 of the 142 cases,in which 11 cases were positive for both HDV RNA and HDAg,8 cases showed HDV RNA(+) HDAg(-),and 9 cases exhibited HDV RNA(-) HDAg(+).Strong expression of HDAg was shown in the bollooning degeneration hepatocytes and hepatocytes near piecemeal necrosis region. The presence of both HDV and HBcAg markers was disclosed in 19 cases. Incidence of early cirrhosis in CAH superinfected with HDV was much higher than that of CAH without HDV superinfection(P<0.05).The significance of these changes and their possible effect on liver damages are discussed.