抗－HEV－IgM对戊型肝炎诊断的意义

THE CLINICAL SIGNIFICANCE OF ANTI-HEV-IgM FOR DIAGNOSIS OF HEPATITIS E VIRUS INFECTION

为探讨患者循环中抗－ＨＥＶ－ＩｇＭ和ＩｇＧ对戊型肝炎诊断的意义，本文对１９９２年至１９９５年期间３５７例急性肝炎标本进行了抗－ＨＥＶ－ＩｇＭ检测，对其中１２７例同步作了抗－ＨＥＶ＋ＩｇＧ测定。结果表明：抗－ＨＥＶ－ＩｇＭ经戊肝急性期后很快下降，而抗－ＨＥＶ－ＩｇＧ则经历了急性期、恢复期乃至更长的时间。还发现在单纯ＨＥＶ感染和ＨＥＶ＋ＨＡＶ感染中，抗－ＨＥＶ－ＩｇＭ反应形式基本相同，但抗ＨＥＶ－ＩｇＧ不同。单纯ＨＥＶ感染中，抗－ＨＥＶ－ＩｇＧ从急性期急剧上升至９５％后，恢复期仍维持在８１．８％的较高水平，而在ＨＥＶ＋ＨＡＶ合并感染中，急性期和恢复期抗－ＨＥＶ－ＩｇＧ仅分别为２３．９％和１２．５％，和单纯ＨＥＶ感染有显著性差异（Ｐ＜０．０１）。本研究表明：抗－ＨＥＶ－ＩｇＭ检测对诊断急性戊型肝炎较抗－ＨＥＶ－ＩｇＧ更有价值。

he aim of the study is to compare the value of anti-HEV-IgM and IgG in the diagnosisof acute hepatitis E. The anti-HEV-IgM were determined in 357 patients suffered from acuteviral hepatitis who were admitted to the hospital from l992 to 1995.In 127 cases,serum an-ti-HEV-IgM and IgG were concomitantly rneasured in acute and convalescent period.107 of357 cases(30%)were diagnosed as acute hepatitis E,and 17 of 127(13.4%)were coinfec-tion of HEV and HAV,The results showed that in acute phase of hepatitis E the anti-HEV-IgM were appeared early but it became sharply declined during early convalescent phase,while anti-HEV-IgG could be maintained for quite a long period. But in patients co-infectedwith HEV and HAV,the detection rates of anti-HEV-IgG were ata low level,they were 23.9% and 12.5% in acute and early convalescent phase respectively,there was significant dif-ference in HEV infection and HEV and HAV co-infection(P<0.01 ). This study suggests that anti-HEV IgM determination ia a very useful important markerfor the diagnosis of acute HEV infection.