摘要
目的:探讨HDVM阴性慢性肝炎患者血清HBV-DNA及组织中HBsAg、HBcAg检测的临床意义。方法:对24例原因不明的慢性肝炎患者应用酶联免疫,吸附试验(ELISA法)检测血清HBV-M(HBsAG、抗HBS、HBcAg、抗HBc、抗HBc),抗HAV-IGM,抗HCV-IgMI、gG,抗HDV-IgMI、GG,抗HEV-IGMI、GG,抗EBV-IGM,抗CMV-IgM,抗TTV-IgM:应用荧光定量聚合酶链反应(FQ-PCR)技术对患者进行血清中乙型肝炎病毒基因(HBVDNA)定量检测;应用免疫组化法,通过肝组织活检测定患者肝组织中HBsAg、HBcAg的表达情况。结果:24例HBVM阴性肝病患者中,6例可检测到HBV-DNA,其中5例肝组织中HBsAG、HBcAg同时阳性,1例HBsAg(+)、HBcAg(-);18例血清HBV-DNA阴性患者中用肝组织活检者3例,其中1例肝组织中HBsAg、HBcAg同时阳性。结论:HBVM阴性不能排除乙型肝炎病毒感染,应结合血清HBV-DNA测定及肝组织中HBcAg、HBcAg的检测,以防漏诊、误诊。
Objective： To explore clinical significance of serum HBV - DNA and liver tissues HBsAg and HBcAg assay in chronic hepatitis patients with negative hepatitis B virus marks. Methods： In twenty - four chronic hepatitis patients of unknown origin the serum hepatitis B virus marks（HBsAg, anti- HBs, HBeAg, anti- HBe, anti- HBc） , anti- HAV- IgM, anti- HCV- lgM,IgG, anti- HDV- IgM,IgG, anti - HEV - IgM, IgG, anti - EBV - IgM, anti - CMV - IgM and anti - TTV- IgM were detcted with ELISA assay, serum HBV - DNA with FQ - PCR and express of HBsAg, HBcAg in liver tissues with immunohistochemistry. Results： In 24 patients, there were 6 cases in which the serum HBV - DNA was positive, in five of the 6 cases both HBsAg and HBcAg were positive and in one the HBsAg was positive and the HBcAg negative. Among 18 patients with serum HBV - DNA（ - ） ,there were 3 cases in which liver biopsies were carried out, In one of them both HBsAg and HBcAg were positive in liver tissues. Conclusion：The possibility of hepatitis B virus infection can not be excluded in chronic hepatitis patients with serum HBVM negative. To avoid misdi- agnosis, HBVM assay must be combined with serum HBV- DNA and liver tissues HBsAg, HBcAg detection in these patients.
出处
《医学理论与实践》
2005年第12期1394-1396,共3页
The Journal of Medical Theory and Practice
