摘要
目的:探讨丙型肝炎病毒感染者血清HCV RNA含量和ALT浓度与肝脏组织病理学损伤之间的关系。方法:应用TaqMan实时荧光定量PCR技术检测681例HCV感染患者血清HCV RNA,电化学发光分析技术检测HBsAg,ELISA检测抗HAV IgM、抗HCV IgG和抗HEV IgM,Bayer全自动生化分析仪检测ALT浓度。H-E染色,光学显微镜观察组织病理损伤程度。结果:681例血清标本中,HCV RNA和抗HCV抗体均阳性和均阴性者分别是150例和420例,HCV抗体阴性而HCV RNA阳性40例,HCV RNA阴性而HCV抗体阳性71例。在排除了甲型、乙型和戊型肝炎病毒感染后,190例HCVRNA阳性患者中,36例患者在HCV RNA检测前后7 d内,曾进行过肝脏组织病理学检测,轻度、中度和重度肝脏病理学损伤患者血清中,HCV RNA浓度及ALT浓度相差均不显著。结论:血清学标志物和病毒核酸都是监测HCV感染的重要指标。HCV RNA浓度、血清ALT浓度与肝脏病理损伤相关性不显著,HCV RNA水平不能反映肝脏病理损伤程度。
Objective : To investigate whether HCV RNA levels can be used as a predictors for hepatocellular injury in patients with chronic hepatitis C, and whether aminotransferase levels can serve as a marker for liver damage. Methods: HCV RNA tilers were determined by reverse transcription and TaqMan real time polymerase chain reaction; HBsAg was determined by electrochemilumince immunoassay. Anti-HAV IgM, Anti-HCV IgG and Anti-HEV IgM were detected by ELISA; ALT levels were detected by enzymatic kinetic assay. The liver damage was observed under light microscope and quantified using the histology activity. Results: Of 681 serum 150 were both positive of HCV RNA and Anti-HCV IgG, 420 were both negative, 40 were only HCV RNA antibody positive, and 71 were only Anti-HCV IgG positive. Thirty-six liver biopsies of 190 HCV RNA positive patients had no marker of HAV, HBV and HEV infection being detected. No significant correlation was noted between liver damage and HCV RNA titer (7=0. 15 P = 0. 22) and ALT level(y=0. 09 P = 0. 12). Conclusion: There is no significant correlation between severity of hepatic injury, HCV RNA and serum ALT level. Hepatic histological evaluation is always required for clinical assessment of patients with chronic hepatitis C.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2004年第12期1307-1309,共3页
Academic Journal of Second Military Medical University
基金
国家自然科学基金(30471542)
作者简介
谭龙益(1957-),男(汉族),博士,副教授.Corresponding author.E-mail:tanlongyi@sohu.com
