Significance of serum IgA in patients with acute hepatitis E virus infection

AIM: To study the significance of serum anti-hepatitis E virus (HEV) IgA in patients with hepatitis E. METHODS: A new method was established to assay anti-HEV IgA, which could be detected in the middle phase of the infection. We compared anti-HEV IgA assay with anti-HEV IgM and anti-HEV IgG assay in sera from 60 patients with positive HEV-RNA. RESULTS: The 60 patients with positive HEV-RNA had both anti-HEV IgA and anti-HEV IgM and 410 patients with negative HEV-RNA were used as control. Periodic serum samples obtained from 60 patients with hepatitis E were tested for HEV RNA, anti-HEV IgM, anti-HEV IgA and anti-HEV IgG. Their HEV-RNA was detectable in the serum until 20±11 d. We used anti-HEV IgM and anti-HEV IgA assay to detect HEV infection and positive results were found in 90±15 d and 120±23 d respectively, the positive rate of anti-HEV IgA was higher than that of anti-HEV IgM and HEV-RNA (P <0.05). CONCLUSION: The duration of anti-HEV IgA in serum is longer than that of anti-HEV IgM, and anti-HEV IgA assay is a good method to detect HEV infection.     

血清miRNA在乙型肝炎诊断和预后中的研究进展

miRNA分子是一大类内源性非编码小RNA分子,通过结合靶mRNA的3’UTR区对基因表达进行调节,导致翻译的抑制或靶mRNA的失稳,从而参与了广泛的生理及病理过程。miRNA也存在于血液循环中,由于其具有相对较小、含量丰富、表达具有组织特异性并且在血清中相对稳定成为了临床上非侵袭性的生物标志物。最近的研究也显示miRNA分子与包括乙型肝炎在内的多种人类疾病有关。本文将总结血清miRNA与乙型肝炎诊断和预后之间关系的最新进展。     

Decreasing serum alpha-fetoprotein levels in predicting poor prognosis of acute hepatic failure in patients with chronic hepatitis B

Background: Background: We carried out a study to predict the prognosis of acute hepatic failure in patients with chronic hepatitis B. Methods: We studied 25 consecutive patients with severe acute hepatitis. Severe acute hepatitis was defined as the development of acute hepatitis with a total serum bilirubin level of more than 15 mg/dl, prolonged prothrombin time (PT) of more than 5 s, and hepatic encephalopathy (HE). All patients were assessed for King's criteria. Positivity for King's criteria was defined as PT more than 100 s, or any three of the following: (age < 10 years or >40 years; cryptogenic or drug-induced hepatitis; jaundice for more than 7 days before the onset of HE; PT > 50 s; and serum bilirubin > 17.5 mg/dl). All but 1 patient had serial serum alpha-fetoprotein (AFP) levels measured every 1–2 weeks. Results: Eleven of 17 patients who died during the study met the King's criteria, whereas none of the surviving patients met the criteria. The sensitivity was 64.7% and the specificity, 100% for King's criteria in predicting a poor prognosis. In 16 of the 17 deceased patients, the AFP levels were reduced while their jaundice increased (sensitivity, 94.1%; specificity, 87.5%). All 17 deceased patients met the King's criteria and/or had reduced AFP levels while their jaundice increased (sensitivity, 100%; specificity, 87.5%). Conclusions: Our observations suggest that the combined use of follow-up AFP levels and King's criteria is helpful in predicting the poor prognosis of severe acute hepatitis superimposed on chronic hepatitis B. Received: August 20, 2001 / Accepted: December 27, 2001     

急性乙型肝炎肝血管病变的特征与预后

目的探讨急性乙型肝炎肝血管炎症、阻塞及破坏与预后的关系．方法用临床及组织学随访、组化、免疫组化及电镜技术，对１５８例急性乙型肝炎肝活检标本血管炎症、阻塞及破坏的特征作了观察．结果在乙型肝炎急性期，肝血管炎症、阻塞及破坏的程度与肝细胞的变性坏死、胆汁分流及预后有关：在１０６例急性乙型肝炎较轻组，被累及的为门管及肝窦，其炎症及破坏程度较轻，患者皆获得临床治愈；而在较重组、急性及亚急性重型肝炎组则与其相反，病死率分别占５％，１００％及４３％（Ｐ＜００５～００１）．结论肝血管受累的大小及程度是发病机制及预后的重要标志     

急性戊型肝炎血清甲胎蛋白浓度变化的观察

[目的]研究急性戊型病毒性肝炎(戊肝)患者甲胎蛋白(AFP)升高的特点与临床意义.[方法]检测、分析戊肝患者肝功能、AFP.[结果]20.3％的戊肝患者AFP升高;AFP升高的峰值可＞3 000μg/L,AFP升高持续时间约4周.AFP升高及下降趋势与转氨酶有相似性,与总胆红素的消长不同步.戊肝AFP正常组与AFP升高组肝功能指标的峰值差异无统计学意义.[结论]急性戊肝患者可出现AFP重度升高;随病程逐渐减退,AFP升高与戊肝病情严重程度无明显关系,可能与急性肝炎后肝细胞再生活跃有关.