摘要
为了更准确、简便而又快速地了解乙型肝炎表面抗原(HBsAg)阴性肝病患者的病因,建立了套式和免疫套式聚合酶链反应(PCR)检测血清中乙型肝炎病毒(HBV)DNA的技术,结合丙型肝炎病毒(HCV)感染指标的检测,对HBsAg阴性肝病患者的病因进行了研究。发现套式PCR能将单次PCR的敏感性稳定地提高1000倍;免疫套式PCR可检测到0.1~0.01pg/L水平。检测HBsAg阴性肝硬化22例(A组)、HBsAg阴性慢性肝炎13例(B组)、HBsAg阴性和乙型肝炎病毒核心抗体(抗-HBc)阳性正常对照组30例(C组)及HBsAg(+)/HBeAg(-)肝硬化患者12例(D组),分别有45.5%、30.8%、13.3%和100%患者血清中HBVDNA阳性。HBVDNA在一些抗-HBs(+)肝病患者和所谓健康人的血清中也存在。A、B两组检出有HBV和(或)HCV感染患者分别占81.8%和53.8%。提示套式和免疫套式PCR是简便、快速而又高度敏感的检测方法;HBV感染可能是引起HBsAg阴性慢性肝病的重要原因,且HBsAg阴性肝病病因大多与病毒感染有关;应该重新认识自然感染者血清中抗-HBs的临床意义。
Inordertofindoutrapidlythecausesoftheliverdiseasessuferedbypatientswithneg-ativehepatitisBsurfaceantigen(HBsAg),nestedpolymerasechainreaction(PCR)andmultipleclonedantibodycapturePCRtechniqueswereestablishedtoexamineserumhepatitisBvirus(HBV)DNA.ByusingbothtechniquesalongwiththeexaminationofhepatitisCvirus(HCV)infection,thecausesofchronicliverdiseaseswithnegativeHBsAgwerestudied.Itisfoundthatnested-PCRcanincreasethesensitivityofsinglePCRmorethan1000foldandmultipleclonedantibodycapture-PCRcandetectcon-centrationofHBVDNAaslowas0.1~0.01pg/L.HBVDNApositivepatientswerefoundin45.5%,30.8%,13.3%and100%respectivelyofthepatientssuferingfromlivercirhosiswithnegativeHBsAg(groupA,22cases),chronichepatitiswithnegativeHBsAg(groupB,13cases),normalsubjectswithnegativeHBsAgandpositivehepatitisBcoreantibody(HBcAb,groupC,30cases)andlivercirhosiswithpositiveHBsAgandnegativeHBeAg(groupD,12cases).HBVDNAcanbealsofoundintheserumofHBsAbpositivepatientsandsubjectssupposedtobehealthy.81.8%and53.8%ofthepatientswereinfectedwithHBVand/orHCVingroupAandgroupBrespectively.Altheseresultssuggestthatnested-PCRandmultipleclonedantibodycaputure-PCRarerapidandhighlysensitivemethodsforde-tectionofserumHBVDNA.HBVinfectionisanimportantcauseofchronicliverdiseasesinpatientswithnegativeHBsAg.ThecausesofmostoftheHBsAg-negativechronicliverdiseasesarerelatedwithinfectionofviruses.TheclinicalsignificanceofserumHBsAbinnaturalyinfectedpatientsshouldbere-considered.
出处
《中华内科杂志》
CSCD
北大核心
1996年第8期537-541,共5页
Chinese Journal of Internal Medicine
关键词
聚合酶链反应
乙型肝炎病毒
乙型肝炎
表面抗原
PolymerasechainreactionHepatitisBvirusHepatitisBsurfaceantigensLiverdiseases