抗－HBcIgM定性分析在乙肝治疗恢复期的临床指导意义

The clinical significance of qualitative analysis on anti-HBcIgM in hepatitis B during the recovery period

目的以乙肝标志物核心抗体阳性的患者为分析对象，定性检测抗-HBcIgM，探讨其在乙肝治疗恢复期的临床指导意义。方法使用周相放射免疫分析法定性检测抗-HBcIgM。结果统计学分析采用标准化法比较。感染期模式组IgM平均阳性率44．2％。非治疗患者IgM阳性率62．9％，高于组平均阳性率。治疗患者IgM阳性率28．8％，低于组平均阳性率；恢复期模式组IgM平均阳性率10．4％。非治疗患者IgM阳性率12．5％，高于组平均阳性率。治疗患者IgM阳性率0，低于组平均阳性率；88例复检者，IgM阳性率首次检测83％，第二次27．3％，第二次17．6％。治疗后。复检者乙肝两对半模式好转率20．5％，IgM检测阴性好转率69．3％。结论抗一HbclgM与乙肝的预后恢复呈正相关，当抗病毒药物治疗有效时，IgM快速转阴。

Objective To explore the clinical significance of anti-HBc IgM in hepatitis B during the recovery period by qualitatively detecting this IgM in patients with HBcAb positive. Methods Anti-HBc IgM was detected by using radioimmunoassay. Results Standardized comparison was applied in statistical analysis. In the infective stage, the positive role of IgM was higher in non-treatment group than in the pattern group （ 62.9% vs. 44.2% ） while it is lower in treatment group than in the pattern group （ 28.8% vs. 44.2% ）. In recovery stage, the positive raate of IgM was higher in non-treatment group but was lower in treatment group than in the pattern group（ 12.5% vs. 0.0% vs. 10.4% ）. The first detection rate was 83%, the second 27.3%, and the third 17.6% in 88 patients with repeat examination. After treatment, the improvement rate of HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb was 20.5% and the negative rate of IgM was 69.3%. Conclusions Anti-HBc IgM is positively associated with the prognosis and recovery of hepatitis B ; when antiviral agents are effective, IgM rapidly becomes negalive. Detection of IgM during treatment can more accurately predict the recovery and prognosis of hepatitis B.