摘要
为探讨慢性活动性肝炎患者急性加重的病因,对15例患者进行肝细胞内HBV DNA(乙肝病毒脱氧核糖核酸)原位杂交研究,同时检查血清与肝内HBV标志及肝内HDAg。发现:①60.0％(9/15)患者存在HBV活动性复制或HBV复制重新激活,观察到表达浆膜型HBcAg肝细胞多紧紧毗邻肝细胞坏死灶;②20.0％(3/15)患者肝内HBsAg或(和)HBVDNA阳性,虽无HBcAg表达,但见到浆膜型HBsAg表达或含HBV DNA肝细胞与肝细胞坏死灶关系密切的表现:③13.3％(2/15)患者有HDV二重感染;④1例患者缺乏HBV感染标志。表明慢性活动型肝炎急性加重主要与HBV活动性复制、HBV复制重新激活或HBV感染持续存在有关,其次是HDV二重感染,少数病例可能存在HAV或HCV的重叠感染。
To explore etiology of acute exacerbation in severe chronic active hepatitis,HBVDNA in situ hybridization was carried out in a group of patients,combined with detection of HBV markers in serum and liver as well as intrahepatic HDAg.Four subgroups were identified based on the etiological evidence.(1) 60.0% cases were still undergoing HBV active replication or reactivation in which HBcAg cytoplasmic and membreneous expression was often associated with the hepatic necrosis foci; (2) in 20% cases with HBsAg or HBVDNA,despite absence of HBcAg expression,membraneous and homogeneous HBsAg expression was also closely related to hepatic necrosis; (3) 13.3% cases were with intrahepatic HDAg; (4) the remaining single case had no HBV infection evidence.All these findings suggest that HBV active replication or reactivation was the major cause of these exacerbation in severe chronic active hepatitis.In addition,HDV superinfection accounted for over 10% exacerbation and hepatitis V and C virus superinfection may contribute to some episodes of exacerbation.
出处
《同济医科大学学报》
CAS
CSCD
北大核心
1990年第3期149-152,共4页
Acta Universitatis Medicinae Tongji
关键词
重型肝炎
病因
丁肝病毒
乙肝病毒
hepatitis, chronic active
HDV superinfection
virus replication
HBVDNA in situ hybridization
