病毒性乙型肝炎病人粪便中检出HBsAg的纵向观察

1982~84年,在××单位乙肝爆发流行后的5~7个月,对13例乙肝病人(其中7人作为系统观察对象),进行了粪便中HBsAg的检测。检测用RPHA和ELISA两种方法,均进行了中和试验,任一方法阳性即判为阳性。检测结果,按人9/13(69.2%)阳性,按采便份数26/86(30.2%)阳性。对14份阳性粪便做了免疫电镜检测,发现3份有小片聚集的20~28 nm类似HBsAg球形颗粒,并发现一份有类似丹氏颗粒和短小管状颗粒。球形颗粒与血中所见极相似。由此看来,在乙肝恢复期,HBsAg消失,抗-HBs或抗-HBc转阳的这个阶段,粪中是可能排出HBsAg的。

Detection of HBsAg in the feces of viral hepatitis B patients by longitudinal studies

From 1982 to 1984, a longitudinal observation has been undertaken in a population where an outbreak of viral hepatitis B in Oct. 1982. About 5-7 months after the outbreak. 13 patients with viral hepatitis B were studied by RPHA and ELISA for detection of HBsAg in feces. Presence of HBsAg was confirmed by specific blocking procedure. HBsAg was found in feces in 69.2% (9/13) of patients, and 30.2% (26/86) of samples collected. 14 faecal specimens found to be positive for HBsAg by RPHA or ELISA were examined by immune electron microscopy. Small aggregates of 20-28 nm HBsAg spherical particles were found in three fecal samples. 40-50 nm simillar Dane''s particles were also detected in one specimen. Only rarely tubes were found too. As mentioned above, we suggest that in convalescent period of viral hepatitis B the HBsAg might be excreted through feces when HBsAg was not detected but seroconveftion for anti-HBc or anti-HBs occurred in serum.