不同肝炎病毒感染模式对慢性肝炎病情的影响研究

A STUDY OF THE EFFECT ON THE STATE OF PATIENTS WITH CHRONIC HEPATITIS BY DIFFERENT SUPERINFECTION MODELS OF HEPATITIS VIRUS

目的：探讨慢性肝炎病人中ＨＢＶ、ＨＣＶ、ＨＤＶ和ＨＧＶ四型肝炎病毒的感染和重叠感染对慢性肝炎的病情及预后的影响。方法：选择慢性肝炎病人１３６例，应用ＰＣＲ方法检测ＨＢＶＤＮＡ、ＨＣＶＲＮＡ、ＨＤＶＲＮＡ和ＨＧＶＲＮＡ，用ＥＬＩＳＡ法检测ＨＢＶ、ＨＣＶ、ＨＤＶ和ＨＧＶ其他血清学标志物。结果：上述四型肝炎病毒的感染模式为：ＨＢＶ、ＨＢＶ＋ＨＣＶ、ＨＢＶ＋ＨＤＶ、ＨＢＶ＋ＨＧＶ、ＨＣＶ和ＨＢＶ＋ＨＣＶ＋ＨＧＶ。六种感染模式的阳性率分别为６３．２％、１３．２％、１．５％、１２．５％、２．９％和６．６２％。除了慢性轻度型外，其余各型肝炎中上述重叠感染模式阳性率均明显高于单纯ＨＢＶ感染组。而ｒ－ＧＴ、ＡＬＴ、ＡＳＴ、ＡＬＰ均高于ＨＢＶ组，Ｃｈｅ活性则明显低于ＨＢＶ组，未见ＨＧＶ单纯感染。结论：在ＨＢＶ感染基础上重叠感染ＨＣＶ、ＨＤＶ和ＨＧＶ可使慢性肝炎病情加重，向慢肝重度、慢重肝和肝硬化发展。广西少见单纯ＨＧＶ感染所致的慢性肝炎，说明ＨＧＶ致病作用较弱，而ＨＶＢ感染是广西慢性肝炎主要致病因素，ＨＣＶ少见。

Objective: The effect of hepatitis virus superinfection on the state of patients with chronic hepatitis , especially the superinfection of hepatitis G virus, was far from investigation because of the absence of testing methods before The presence of HBV,HCV,HDV and HGV was investigated in the study for exploring the role of the superinfection models of chronic hepatitis virus in effect on the state of patients with chronic hepatitis Methods:136 sera of patients with chronic hepatitis was tested the HBVDNA, HCVRNA, HDVRNA and HGVRNA by PCR The other marks of HBV, HCV, HDV and HGV were tested by ELISA method The wholesets of liver function was also examined in the same time Results: there were six infection models: HBV,HBV+HCV, HBV+HDV, HBV+HGV, HCV, HBV+HCV+HGV in the sera of patients with chronic hepatits The rate of superinfection medels: HBV+HCV, HBV +HDV, HBV+HGV and HBV+HCV+HGV was higher than that of HBV model The level of r -GT, ALP, AST, ALP, ALP was higher and the activity of Che was lower than that in the group of HBV infecting alone No HGV inffecting aline was seen in the subject sera Cinclusion:The study results suggested that the superinfecting of HCV, HDV and HGV on the HBV infection might make the chronic hepatitis severe and develop more serious liver disorder The fact that there was mo HGV infection alone in Guangxi patients with chronic hepatitis demonstrate that HGV was light in pathogenesis, and the infection of HBV is the main factor in chronic hepatitis, and HCV infection is not often encountered