丙型肝炎患者血清和外周血单个核细胞中HCVRNA检测及意义

DETECTION OF HEPATITIS C VIRUS RNA IN SERUM AND IN PERIPHERAL BLOOD MONONUCLEAR CELLS OF PATIENTS WITH HEPATITIS C

目的了解丙肝患者血清和外周血单个核细胞（ＰＢＭＣ）中ＨＣＶＲＮＡ存在情况及其临床意义。方法应用套式ＰＣＲ检测４６例急性丙型肝炎（丙型肝炎以下简称丙肝）和４２例慢性丙肝患者血清和ＰＢＭＣ中ＨＣＶＲＮＡ。结果慢性丙肝患者ＰＢＭＣ中ＨＣＶＲＮＡ检出率显著高于急性丙肝患者（Ｐ＜０．００１）；急、慢性丙肝患者血清和慢性丙肝患者ＰＢＭＣ中ＨＣＶＲＮＡ检出率显著高于ＡＬＴ正常的抗－ＨＣＶ阳性者（Ｐ＜０．００１）；２例患者血清中ＨＣＶＲＮＡ阴性，ＰＢＭＣ中可测及，１２例患者血清抗－ＨＣＶ阴性，而血清ＨＣＶＲＮＡ阳性。结论血清ＨＣＶＲＮＡ检测有助于抗－ＨＣＶ阴性丙肝的诊断和早期诊断；丙肝的肝损害可能与ＨＣＶＲＮＡ血症有关；ＰＢＭＣ中ＨＣＶ感染在丙肝的慢性化和慢性肝损害中可能起一定作用，ＰＢＭＣ中可贮存ＨＣＶＲＮＡ。

In order to investigate the existence of hepatitis C virus(HCV) RNA in serum and in peripheral blood mononuclear cells(PBMC) of patients with hepatitis C and to explore its clinical significance.Methods HCV RNA was detected by nested-polymerase Chain reaction(Nested-PCR)in serum and in PBMC of 46 patients with acute hepatitis C(AHC) and 42 patients with chronic hepatitis C(CHC). Results lt was found that the positive rate of HCV RNA in PBMC of patients with CHC has been markedly higher than that of patients with AHC(P<0. 001).The positive rates of HCV RNA in serum of patients with AHC and CHC and in PBMC of patients with CHC have been significantly higher than those of anti-HCV positive patients with normal ALT level (P<0.001); 2 patients were negative of HCV RNA in serum but positive in PBMC,12 were negatlve of anti-HCV, but positive of HCV RNA in serum. Conclusion(1)Detection of serum HCV RNA by nested-PCR might be helpful to the diagnosis or early diagnosis of anti-HCV negative hepatitis C,(2) the liver damage in patients with hepatitis C might be correlated with HCV-viremia;(3) infection of HCV in PBMC might play an important role in chronic liver damage and chronicity in patients with HC and therefore chronicity of the clinical course;(4) PBMC might be considered as a 'reservoir' of HCV.