庚型肝炎临床和病理特征

目的探讨庚型肝炎（ＨＧ）临床和病理特征。方法采用逆转录聚合酶链反应（ＲＴ－ＰＣＲ）检测血清ＨＧＶＲＮＡ；用庚型肝炎病毒（ＨＧＶ）ＮＳ５区抗原制备单克隆抗体（ＭｃＡｂ），对２２例临床和／或病理确诊的急、慢性庚型肝炎进行肝脏免疫组化。结果ＨＧＶ感染的血清学模式以重叠ＨＢＶ，ＨＣＶ，ＨＡＶ或ＨＥＶ二重感染为主，占６３．６％（１４／２２），单独ＨＧＶ感染者占３６．４％（８／２２）；ＨＧＶ在肝脏内分布呈散在胞浆型。结论ＨＧＶ单独感染者临床多呈隐匿性发病，症状轻，慢性化程度高     

乙型肝炎患者血清Pre-S-2抗原的意义

目的研究ＰｒｅＳ２抗原与乙型肝炎患者ＨＢＶ标记的关系．方法血清ＨＢｓＡｇ（＋），ＨＢｅＡｇ（＋），ＨＢｃＡｂ（＋）的乙型肝炎患者２６例，血清ＨＢｓＡｇ（＋），ＨＢｅＡｂ（＋），ＨＢｃＡｂ（＋）的乙型肝炎患者４７例及健康献血者２０例，血清用ＲＩＡ法检测ＰｒｅＳ２抗原及用ＰＣＲ法检测ＨＢＶＤＮＡ．结果血清ＨＢｓＡｇ（＋），ＨＢｅＡｇ（＋），ＨＢｃＡｂ（＋）的乙型肝炎患者２６例，ＰｒｅＳ２抗原与ＨＢＶＤＮＡ均阳性（１００％）；血清ＨＢｓＡｇ（＋），ＨＢｅＡｂ（＋），ＨＢｃＡｂ（＋）的乙型肝炎患者４７例，ＰｒｅＳ２抗原３０例阳性（６３８％），１７例阴性（３６２％），ＨＢＶＤＮＡ３２例阳性（６８１％），１５例阴性（３１９％），ＰｒｅＳ２抗原与ＨＢＶＤＮＡ均阳性２８例（５９６％），均阴性１４例（３００％）．健康献血者２０例，ＰｒｅＳ２抗原阳性１例（５０％），阴性１９例（９５０％），ＨＢＶＤＮＡ阳性２例（１００％），阴性１８例（８００％），ＰｒｅＳ２抗原及ＨＢＶＤＮＡ均阳性０例（０％），均阴性１８例（８００％）．结论ＰｒｅＳ２抗原可作为预测慢性乙型肝炎患者病情活动与传染的标志．     

肝炎患者肝组织中庚型肝炎病毒相关抗原的表达

目的 研究庚型肝炎病毒（ＨＧＶ）相关抗原在肝组织中定位。方法 采用免疫组织化学方法,用抗－ＨＧＶ非结构蛋白５（ＮＳ５）单克隆抗体（ＭｃＡｂ）对１９６例肝炎患者肝组织中的ＨＧＶ相关抗原进行了检测。结果 １９６例肝炎患者肝组织中的ＨＧＶ相关抗原表达阳必国２５．０％;在血清中ＨＧＶＲＮＡ呈阳性患者肝组织中抗原检出率为３８．３％;单一感染者肝组织中抗原表达阳性率为６６．７％;阳性信号位于胞浆中,阳性信号表     

乙型肝炎病毒感染与消化性溃疡的关系

目的探讨乙型肝炎病毒（ＨＢＶ）感染与消化性溃疡（ＰＵ）之间的关系及其在ＰＵ形成中的作用机制．方法１９８９１０／１９９５０９因消化道症状而进行内镜检查及血清ＨＢＶＭ检测的３３４例患者，并对结果进行统计学处理分析．结果在３３４例患者中有４６例感染了ＨＢＶ，列为ＨＢＶ感染组，检出ＰＵ１９例（４１３％），其余２８８例列为ＨＢＶ非感染组，检出ＰＵ６６例（２２９％），两组有极显著差异（Ｐ＜００１）．在３３４例患者中有ＰＵ８５例，列为ＰＵ组，血清ＨＢＶＭ阳性率为２２４％，其中胃溃疡（ＧＵ）３１例（３６５％），十二指肠溃疡（ＤＵ）３５例（４１２％），复合性溃疡（ＣＵ）１９例（２２３％），ＧＵ，ＤＵ及ＣＵ血清ＨＢＶＭ阳性率分别为２５８％（８／３１），２２９％（８／３５）及１５８％（３／１９），三组相互间比较无显著性差异（Ｐ＞００５）；其余２４９例列为非ＰＵ组，血清ＨＢＶＭ阳性率１０８％，两组有极显著差异（Ｐ＜００１）．ＰＵ组与全国城市人群标化ＨＢＶＭ阳性率７９％比较有极显著差异（Ｐ＜００１）．结论ＨＢＶ感染与ＰＵ关系密切，是参与ＰＵ发病的一个因素．     

24例非甲—戊型肝炎患者血清庚肝病毒RNA检测结果分析

采用逆转录－套式聚合酶链反应（ＲＴ－ｎＰＣＲ）技术对２４例非甲－戊（Ａ－Ｅ）型肝炎患者进行庚肝病毒ＲＮＡ（ＨＧＶ－ＲＮＡ）检测。结果：ＨＧＶ－ＲＮＡ阳性６例（２５．０％），其中急性肝炎１例（１／９）、慢性肝炎２例（２／９）、肝为肝硬变３例（３／４）；１例有输血史，余５例均无输血或血浆史。提示庚肝病毒可能为非Ａ－Ｅ型肝炎的病原体之一，且存在输血外传播途径。     

血清抗-HBs阳性慢性肝病患者的病因研究

目的部分抗－ＨＢｓ阳性者仍有活动性肝病存在，其病因还不十分清楚．本研究旨在探讨血清抗ＨＢｓ阳性慢性肝病患者的病因．方法应用套式聚合酶链反应检测血清抗ＨＢｓ阳性慢性肝病患者血清中ＨＢＶＤＮＡ和ＨＣＶＲＮＡ．患者３２例，男２５例，女７例，平均年龄４１７岁（２１岁～６３岁），其中慢性肝炎１８例，肝硬变１４例．９例慢性肝炎和５例肝硬变经肝活检证实，其余为临床诊断．结果血清中ＨＢＶＤＮＡ和ＨＣＶＲＮＡ的检出率分别为６２５％（２０／３２）和２８１％（９／３２）；ＨＢＶＤＮＡ和（或）ＨＣＶＲＮＡ总检出率为８１３％（２６／３２）．结论血清抗ＨＢｓ阳性慢性肝病患者的病因多数与ＨＢＶ和（或）ＨＣＶ感染有关．     

病毒性肝炎和原发性肝癌患者血清IL2相关指标的意义

目的研究病毒性肝炎和原发性肝癌（ＨＣＣ）患者ＩＬ２，ｓＩＬ２Ｒ，ＩＬ６，Ｔ细胞亚群的变化意义．方法采用双抗体夹心ＥＬＩＳＡ法，ＡＢＳＥＬＩＳＡ法和红细胞花环实验对９４例各型病毒性肝炎和１０例ＨＣＣ进行了ＩＬ２，ＩＬ６，ｓＩＬ２Ｒ和Ｔ细胞亚群的测定，并与６６例健康献血员进行了对照．结果急性肝炎（ＡＨ）ＩＬ２水平增高，恢复期下降；而慢性肝炎（中重）、肝炎肝硬变（ＬＣ）、ＨＣＣ患者血清ＩＬ２水平明显低于慢性肝炎（轻）（Ｆ＝２０２６，Ｐ＜００１）和正常对照（ＮＣ）组．在乙型肝炎、ＨＢＶＤＮＡ阳性组的ＩＬ２水平显著低于ＨＢＶＤＮＡ阴性组．在ＣＨ，ＬＣ，ＨＣＣ组，ＩＬ２与ＣＤ＋４／ＣＤ＋８比值正相关，在各型肝炎和ＨＣＣＩＬ２与ｓＩＬ２Ｒ，ＩＬ６无相关关系．ＨＣＣ组的ＩＬ６水平高出正常１０倍以上，较各型肝炎组也明显升高（Ｆ＝３００７，Ｐ＜００１）．结论在病毒性肝炎和ＨＣＣ存在免疫功能紊乱和低下，淋巴因子网络失衡，这与肝炎和ＨＣＣ的病理生理机制有关，也为临床ＩＬ２治疗提供了理论依据．ＩＬ６的极显著增高有助于ＨＣＣ的诊断．     

丙型肝炎病毒核心抗原转位表达抑制肝(癌)细胞

目的探讨丙型肝炎病毒核心抗原的转位表达与肝（癌）细胞凋亡的关系及其意义．方法采用免疫组织化学方法检测ＨＣＶ核心区抗原Ｃ２２在肝硬变（ＬＣ）、肝细胞肝癌（ＨＣＣ）组织中的分布;同时对连续切片进行原位凋亡检测并计算凋亡指数．结果ＨＣＶ核心区抗原定位于肝细胞或肝癌细胞的胞质或胞核中,在ＬＣ组织中,Ｃ２２呈弥漫或灶状分布于肝细胞胞质,偶见胞核阳性的肝细胞,阳性率为６０７％;Ｃ２２抗原在ＨＣＣ细胞中以核阳性分布为主,阳性率为３７６％,癌旁肝组织以胞质阳性为多见．ＨＣＣ中ＨＣＶ核心抗原的核阳性率（７５０％,１５例／２０例）和阳性细胞数明显高于其在ＬＣ（１７７％,６例／３４例）及癌旁肝组织（１１８％,２例／１７例）中的阳性率（Ｐ＜００５）和阳性细胞数．在ＨＣＣ中,ＨＣＶ核心抗原核转位表达的癌组织的ＡＰＯＰＬＩ凋亡指数值（０１７４±００９３）显著低于胞质阳性的癌组织（０５１２±０１１３,Ｐ＜００１）．结论ＨＣＶ感染与我国ＬＣ,ＨＣＣ的发生关系密切,ＨＣＶ核心抗原在肝癌组织中常发生核转位表达,这种核转位表达使肿瘤细胞凋亡受到抑制,从而促进肿瘤组织的恶性生长．     

PCR检测献血员乙肝感染状况

目的对部分献血员中乙型肝炎感染状况进行调查．方法用ＰＣＲ法对检查合格的２９０份献血血样进行ＨＢＶ＿ＤＮＡ检测．结果本组２９０份血样中ＨＢｓＡｇ，ＨＢｅＡｇ全部呈阴性．１６７例ＨＢＶＭ阳性；其中８０例单项抗ＨＢｓ阳性，５０例单项抗ＨＢｃ阳性，１９例抗ＨＢｓ和ＨＢｃ两项阳性，１２例抗ＨＢｅ和抗ＨＢｃ两项阳性；６例抗ＨＢｓ，抗ＨＢｅ和抗ＨＢｃ三项阳性，而ＨＢＶ－ＤＮＡ的阳性率在各组中分别为８８％（７／８０），２６０％（１３／５０），１０５％（２／１９），７５０％（９／１２），３３３％（２／６）．１２３例ＨＢＶＭ阴性，ＨＢＶ－ＤＮＡ的阳性率为１６％（２／１２３）．２９０例中ＨＢＶ－ＤＮＡ的总检出率为１２１％（３５／２９０）．结论合法献血员中存在着乙肝病毒感染者．     

PCR检测HBV感染患者血清HBV DNA的临床意义

目的探讨急、慢性乙型肝炎及与ＨＢＶ感染相关的肝硬变和肝癌患者血清ＨＢＶＤＮＡ的临床意义．方法应用ＰＣＲ技术检测不同ＨＢＶ感染２０５例，患者血清ＨＢＶＤＮＡ，并与正常人２０例作比较．结果ＨＢＶ感染患者２０５例血清ＨＢＶＤＮＡ阳性率为６９３％，慢性乙肝、乙肝后肝硬变和肝癌患者的阳性率分别为７６４％，７１９％和７００％，显著高于急性乙肝患者２１７％的阳性率（Ｐ＜００１）；ＨＢｅＡｇ（＋）患者血清ＨＢＶＤＮＡ阳性率为９３６％，显著高于ＨＢｅＡｇ（－）抗ＨＢｅ（＋）／（－）和ＨＢｓＡｇ（－）患者的阳性率（４５６％，２５０％和１２５％，Ｐ＜００１）；血清ＨＢＶＤＮＡ阳性和阴性两组患者的血清ＡＬＴ水平无明显差异（Ｐ＞００５）．结论血清中ＨＢＶＤＮＡ持续存在可能与乙型肝炎的慢性化有关，而与ＨＢＶ感染患者的肝损伤无明显关系     

慢性肝病患者肝组织中HGV抗原的表达及意义

目的探讨慢性肝病患者组织中庚型肝炎病毒（ＨＧＶ）表达与意义。方法应用免疫组织化学方法以鼠抗ＨＧＶＮＳ５甲克隆抗体检测１４２例慢性肝病患者肝组织中ＨＧＶ抗原，部分患者采用ＲＴ－ＰＣＲ方法检测其血清中ＨＣＶＲＮＡ。结果１４２例肝病患者中，２９例（２０．４％）组织中检出ＨＧＶ抗原，肝硬化组（４２．９％，１２／２８）较慢性肝炎（１５．９％８／１１）和肝癌（１４．３％，９／６３）组检出率高。阳性信号位于胞浆中，阳性细胞可成散在、簇状或弥漫性分布。阳性细胞周围可有炎性坏死；肝癌患者抗原阳性细胞主要位于癌旁肝组织，癌巢中仅偶见少数散在分布的阳必细胞；绝大多数组织抗原阳性者其血清ＨＧＶＲＮＡ为阳性。有４例患者组织中ＨＧＶ抗原阳性但其血清ＨＧＶＲＮＡ阴性。结论ＨＧＶ可在慢性肝病包括肝细胞肝癌患者肝组织中表达，ＨＧＶ感染在慢性肝炎病期进展及肝癌发生中具有一定意义。     

HGV/GBV-C infection in patients with acute hepatitis of different etiology and in patients with chronic hepatitis C

To investigate the prevalence of hepatitis G virus (HGV/GBV-C) in patients with liver disease and to confirm its hypothesized ability to cause liver damage, we studied 130 subjects; 61 had chronic hepatitis C virus infection and 69 had acute hepatitis of either defined etiology (n = 57) or of unknown origin (n = 12). Positivity for HGV/GBV-C RNA was detected in 10 of the 61 subjects with chronic hepatitis C (16.3%) and in 11 of the 57 subjects with acute hepatitis of defined etiology (19%), whereas we failed to detect HGV/GBV-C viremia in subjects with hepatitis of non-established etiology. Patients exhibiting positivity for HGV/GBV-C RNA were found to be comparable to those exhibiting negativity for HGV/GBV-C RNA in terms of both liver function tests and Knodell's score (in liver biopsies); the affect of HGV/GBV-C infection on the biohumoral and histological activity in patients with chronic hepatitis C therefore appears to be minimal or absent. Similar clinical features were observed in patients with acute hepatitis of known etiology whether they were positive or negative for HGV/GBV-C RNA. However, long-term clinical studies are still required to clarify the actual impact of HGV/GBV-C co-infection. In our geographic, i.e., a region or north-east Italy, HGV/GBV-C infection appears to be strictly related to intravenous drug use, and this agent does not seem to be responsible for acute hepatitis of unknown etiology; other etiological agents are probably involved. Received Feb. 17, 1997; accepted June 27, 1997     

A study on pathogenicity of hepatitis G virus

AIM: To study the pathogenicity of hepatitis G virus (HGV) and observe the genesis and pathological process of hepatitis G. METHODS: HGV-RNA in serum was detected by RT-PCR assay. The immunohistochemical assays of liver tissue were performed with HGV monocoloned antibody (McAb) expressed from the region of HGV NS5 nucleic acid sequence. The clinical and pathological data of 52 patients with hepatitis G were discussed. In animal experiment, the Chinese Rhesus monkeys were infected with the serum of a patient with HGV infection. And the dynamic changes in serology and liver histology of animals were observed. RESULTS: One hundred and fifty-four patients with HGV-RNA positive were selected from 1552 patients with various kinds of hepatitis. Of 154 patients with HGV infection, 52 were infected with HGV only, which accounted for 33.8 (52/154) and 102 with positive HGV-RNA were super-infected with other hepatitis viruses, which accounted for 66.2 (102/154). The clinical and pathological observation showed that the acute and chronic hepatitis could be induced by HGV. The slight abnormality of transaminases ALT and AST in serum of monkeys lasted nearly 12 months and histological results showed a series of pathological changes. CONCLUSION: HGV is a hepatotropic virus and has pathogenicty.     

庚型肝炎病毒感染对急性肝炎致病性的探讨

目的 探讨急性肝炎患者肝组织中庚型肝炎病毒（ＨＧＶ）的感染状况及其致病性。方法 采用免疫组织化学方法对３７例血清学肝炎病毒标记甲￣戊型均阴性的急性肝炎患者肝穿肝组织中的ＨＧＶ ＮＳ５抗原等进行检测,并对ＨＧＶ感染的致病性进行研究。结果 ＨＧＶ ＮＳ５抗原的检出率为３７．８％（１４／３７）,其中ＨＧＶ ＮＳ５单项阳性４例（急性庚型肝炎组）。结果 ＨＧＶ ＮＳ５抗原的检出率为３７．８％（１４／３７）,     

High prevalence, low pathogenicity in hepatitis G virus in kidney transplant recipients

BACKGROUND: Prevalence and pathogenicity of hepatitis G virus infection in long-term renal transplant recipients, are not fully known. AIM: To evaluate long-term impact of HGV infection on liver disease of renal transplanted patients. PATIENTS AND METHODS: A total of 155 hepatitis B surface antigen negative kidney transplant recipients, followed for a mean of 11 years after renal transplantation, were studied. Of these 48 (31%) patients had persistently elevated serum aminotransferase values. Frozen serum samples were tested for HGV-RNA and HCV-RNA by nested reverse transcribed polymerase chain reaction, and for anti-hepatitis G virus and anti-hepatitis C virus by enzyme-linked immunosorbent assay Hepatitis C virus-RNA was typed by a line probe assay and quantified by a branched DNA signal amplification assay RESULTS: Hepatitis G virus-RNA was detected in 37 (24%) patients and anti-hepatitis G virus in another 26 (17%). Seventy (45%) patients had serum anti-hepatitis C virus and 63 of these (90%) had serum hepatitis C virus-RNA. Hepatitis G virus-RNA positive and negative patients were similar in terms of age, sex, duration of dialysis, rate of transfusion, chronic liver disease, rate of hepatitis C virus infection and immunosuppressive therapy. Fifteen (41%) hepatitis G virus-RNA seropositive patients were hepatitis C virus co-infected. Hepatitis C virus-RNA levels were significantly lower in the 15 hepatitis C virus/hepatitis G virus co-infected patients than in the 48 patients with hepatitis C virus infection only (2.2 vs 10.8 MEq/ml, p = 0.02). Only 3 hepatitis G virus carriers had persistently elevated alanine aminotransferase compared to 29 hepatitis C virus carriers (14% vs 60%, p < 0.001), 10 patients co-infected with both hepatitis G virus and hepatitis C virus, and in 6 patients with neither infection (67% vs 8%, p < 0.001). CONCLUSIONS: Hepatitis G virus infection is common among kidney transplant patients, it carries a low risk of chronic liver disease even in long-term follow-up. Low levels of hepatitis C virus-RNA found in hepatitis G virus carriers suggest an interaction between these two viruses in immunosuppressed patients.