人微小病毒B19感染者血清生化改变的初步分析

Preliminary study of biochemical changes in serum of patients with human parvovirus B19 infection

目的研究感染人微小病毒 Ｂ１９（ＰＶＢ１９）的病毒性肝炎患者的血清生化改变情况。方法用巢式聚合酶链式反应法 检测病毒性肝炎患者和对照者的共 ４７３份血清中的 ＰＶＢ１９ ＤＮＡ，对 ＰＶＢ１９ ＤＮＡ阳性血清进行血清生化测定并对多 项生化指标进行多元统计分析。结果共检出 １７份 ＰＶＢ１９ ＤＮＡ阳性血清。 １７份血清中多项离子、肌酐、尿酸、葡萄糖、 乳酸脱氢酶等的水平正常，而尿素氮、胆红素、蛋白、肝脏酶的水平大多偏离正常值；经多元统计分析发现临床诊断为病 毒性肝炎的ＰＶＢ １９感染者与有其他症状的ＰＶＢ１９感染者在肝细胞受损程度及肝功能不全程度上有显著性差异。结 论感染ＰＶＢ１９不会引起离子水平、肾功能、糖代谢水平等的改变，但病毒性肝炎患者感染ＰＶＢ １９后血清生化改变与 其他患者不同，是否可用血清肝脏酶和胆红素水平的异常作为ＰＶＢ１９感染的辅助诊断还需进一步研究。

Objective To investigate the biochemical changes in the serum of patients with parvovirus B19 (PVB19) infection and of those with other diseases. Methods A total of 473 serum samples were obtained from 205 patients with viral hepatitis and 268 patients suffering other diseases, and nest PCR tests were performed to detect PVB19 DNA. Serum samples positive for PVB 19 DNA were further examined biochemically, the results of which analyzed statitically. Results Eight patients with viral hepatitis, along with 9 suffering other diseases were found PVB19 DNA-positive. Biochemical examination of the 17 positive serum samples revealed that the serum levels of K+, Na+, Ca2+, P, Mg2+, Cl-, creatinine (Cr), glucose, uric acid (UA), lactic dehydrogenase (LDH) and total protein remained normal, while blood urea nitrogen (BUN), albumin (ALB), alanine aminotransferase (ALT), total bilirubin (TBil), direct bilirubin (DBil) and the hepatic enzymes did not. Statistical analysis found significantly more serious hepatocyte damage and hepatic dysfunction in PVB19-infected patients with viral hepatitis than that in patients with other diseases. Conclusions PVB 19 infection does not result in changes in ionic levels, renal function or glucose metabolism, but serum biochemical changes may take place in patients with viral hepatitis in response to PVB 19 infection, which are different from the changes in other patients. The validity of serum hepatic enzymes and bilirubin as indicators for PVB 19 infection is to be further investigated.