35例庚型肝炎临床及酶学变化观察

The clinical and enzymatic changes in patients with viral hepatitis G infection

目的探讨庚型肝炎病毒（ＨＧＶ）感染的临床意义。方法应用逆转录－套式聚合酶链反应（ＲＴ－ｎＰＣＲ）检测１６５例肝炎患者血清ＨＧＶＲＮＡ和血清酶的变化。其中急性肝炎２４例，慢性肝炎７８例，肝硬化１８例，肝癌４例，乙、丙肝携带者４１例。结果在急性黄疸型肝炎中检出单纯性ＨＧＶ感染３例（１２５％），血清ＡＬＴ水平在４８８±６５Ｕ／Ｌ之间，ＡＳＴ在４５２±７１Ｕ／Ｌ之间，ＴＢｉＬ在７７１±１４３μｍｏｌ／Ｌ。急性肝炎酶的升高一般在１个月内降到正常，而ＨＧＶＲＮＡ在ＡＬＴ降到正常后仍持续一段时间才转阴，其中１例发病后９个月转阴。慢性肝炎中检出ＨＧＶＲＮＡ阳性１９例（２４４％），其中单纯性ＨＧＶ阳性４例（５１３％）。肝硬化肝癌中ＨＧＶＲＮＡ阳性４例，其中１例肝硬化为单纯性ＨＧＶ阳性。结论在急性黄疸型肝炎、乙型肝炎病毒携带者、慢性肝炎、肝硬化以及肝癌中均可检出庚型肝炎病毒，为单独感染或与乙、丙型肝炎病毒同时或重叠感染，其传播途径与乙、丙型肝炎的传播途径相同。

For the purpose of making sure the clinical significance of hepatitis G virus, RT-nested PCR was applied to detect HGV RNA in 165 hepatitis patients, which included 24 acute hepatitis, 78 chronic hepatitis, 18 hepaptic cirrhosis, 4 hepatocellularcarcinom and 41 HBV and HCV carriers. The results showed that the infection of HGV existed in all kinds of hepatitis patients. Among the acute hepatitis 12.5% (3/24) was HGV RNA positive. 19 (24.4%) cases were HGV RNA positive in chronic hepatitis, among which 4 cases were simply HGV RNA positive (5.13%). The serum ALT level in 3 cases of simple acute HGV patients was between 488±65U/L, the value of AST between 452±71U/L, the TBiL at about 77.1±14.3μmol/L. All these showed that only HGV infection could lead to acute hepatitis. The rising enzyme dropped to normal about a month later in acute hepatitis while HGV RNA would remain. The problem whether HGV infection is caused by simple acute and chronic hepatitis infection is under investigation.