戊型肝炎病人血清抗-HEV IgG与IgM和HEV RNA的动态变化

DYNAMICS OF ANTI-HEV IgG,ANTI-HEV IgM AND HEV RNA IN SERA OF PATIENTS WITH HEPATITIS E

利用酶联免疫试验（ＥＩＡ）及逆转录－聚合酶链反应（ＲＴ－ＰＣＲ），检测了２１０份急性非甲非乙非丙肝炎患者血清和４０例戊型肝炎（戊肝）病人系列血清。在急性非甲非乙非丙肝炎血清中，抗－ＨＥＶＩｇＧ、抗－ＨＥＶＩｇＭ和ＨＥＶＲＮＡ阳性率分别为６２．８６％、４５．２３％和４０．４８％。在戊肝系列血清检测中，抗－ＨＥＶＩｇＧ阳性率发病１个月内为９２．５％，发病２～６个月１００％，１２个月９４．７％，２４个月４８．６％。抗－ＨＥＶＩｇＭ阳性率发病１个月内为８０％，发病２个月５２．５％，６个月５％。抗－ＨＥＶＩｇＧ出现早，持续时间长，阳性率高。尽管大部分抗－ＨＥＶＩｇＭ阳性血清抗－ＨＥＶＩｇＧ也呈阳性，但也确有少数抗－ＨＥＶＩｇＧ为阴性的。结果表明，抗－ＨＥＶＩｇＧ检测是诊断戊肝感染最重要的方法。

sera from patients with acute NANBNC hepatitis and serial sera of 40 hepatitis E sporadic cases were detected for anti-HEV IgG,anti-HEV IgM,HEV RNA using an enzyme immunoassay (EIA)and RT-PCR.The positive rates of anti-HEV IgG,anti-HEV IgM,HEV RNA in sera of patients with acute NANBNC hepaitits were 62.86%,45.23%,40.48% respectively.Anti-HEV IgG were detected in 92.5% patients within 30 days after onset of illness,in 100% 2～6 months after onset;IgM antibodies were detected in 80% of patients within 30 days after onset of illness,in 52.5% 2 months after onset,in 5% 6 months after onset.In addition,the anti-HEV IgG appeared earlier and persisted longer,as compared with anti-HEV IgM,HEV RNA.Although most of anti-HEV IgM positive sera were also positive for anti-HEV IgG,a small number of them were negative for anti-HEV IgG.The results demonstrated that the detection of anti-HEV IgG is the most important method for diagnosing hepaitits E,but the detection of anti-HEV IgM is also helpful.