肝炎病毒感染者血中SOD GSH-PX LPO含量测定的意义

对５０９例门诊查体者进行了ＡＬＴ及ＨＡＶ、ＨＢＶ、ＨＣＶ、ＨＤＶ、ＨＥＶ标志物的检测；并对检测出的肝炎病毒感染者、肝炎患者以及肝炎病毒标志物阴性者（对照组）的血液进行了ＳＯＤ、ＧＳＨ－ＰＸ、ＬＰＯ测定。结果显示：肝炎病毒感染者、肝炎患者血中ＳＯＤ、ＧＳＨ－ＰＸ的含量，均显著低于对照组（Ｐ＜００５）；ＬＰＯ的含量高于对照组（Ｐ＜００５，Ｐ＜００１），当多种肝炎病毒混合感染时血ＳＯＤ、ＧＳＨ－ＰＸ下降、ＬＰＯ增高更明显，其中以ＨＢＶ、ＨＣＶ、ＨＥＶ三重叠感染及复合型肝炎（ＨＢＶ、ＨＣＶ、ＨＤＶ）时更为显著（Ｐ＜００５），提示：肝炎病毒感染者及肝炎患者血ＳＯＤ、ＧＳＨ－ＰＸ均有不同程度降低，ＬＰＯ却有不同程度增高，并与肝损伤有一定的相关性。     

Prevalence of hepatitis B virus chronic carriers and risk factors for hepatitis B virus infection among Lithuanian army soldiers

The aim of this study was to evaluate the prevalence of hepatitis B serological markers (hepatitis B virus (HBV) superficial antigen (HBsAg)) and risk factors for HBV infection among Lithuanian Army soldiers. The study was carried out in Lithuanian military subunits in 2003. Serum samples were draw from 1,830 soldiers (average age, 21.6 (0.707) years) and tested for hepatitis B infection markers (HBsAg). Questionnaires were used to obtain information about risk factors associated with HBV infection. A total of 1.97% of soldiers was seropositive for HBsAg. The prevalence rate of HBV infection was related to military subunit (p > 0.05). Most of the HBsAg-positive soldiers (53.8%) served 4 to 6 months. Among soldiers who were offered to use drugs, the prevalence of HBsAg was 4.3%; in the remaining group, the prevalence was 1.9%. No association was found between other risk factors for HBV infection and the prevalence rate of the hepatitis B marker. Study data proved the need for health promotion, prophylactic vaccination, and monitoring programs at the Lithuanian Armed Forces.     

Coarse nodular US pattern in hepatic cirrhosis: risk for hepatocellular carcinoma

PURPOSE: To determine the prevalence of the coarse nodular ultrasonographic (US) pattern and its prognostic importance in terms of hepatocellular carcinoma (HCC) risk in hepatic cirrhosis caused by hepatitis B virus (HBV); HBV with hepatitis D virus (HDV), formerly known as hepatitis delta virus; hepatitis C virus (HCV); and alcoholic cirrhosis (ALC) or primary biliary disease (primary biliary cirrhosis [PBC]). MATERIALS AND METHODS: Four hundred two cases of hepatic cirrhosis caused by HBV (94 patients), HDV (100 patients), HCV (100 patients), ALC (63 patients), or PBC (45 patients) were retrospectively reviewed to identify the US pattern present at diagnosis and its possible association with the cause of the disease and subsequent development of HCC during a mean follow-up of 43.9 months +/- 29.9 (SD). Data were analyzed with the chi2, Fisher exact, and log-rank tests and with the Kaplan-Meier method (all two-tailed). RESULTS: The coarse nodular pattern was found in a significantly higher percentage of patients with HDV-related cirrhosis (51%) compared with those with HBV (9%), HCV (9%), ALC (11%), or PBC (9%) (P <.001). This pattern was associated with a significantly increased risk for HCC in patients with cirrhosis and HBV-, HCV-, and ALC-related disease but not in those with HDV-related disease and PBC. CONCLUSION: The coarse nodular pattern is more often seen in patients with HDV-related cirrhosis, and, in this setting (in contrast to HBV-, HCV-, and ALC-related cirrhosis, as well as in PBC), it does not represent an added risk factor for HCC.     

IgA抗-HBc检测对病毒性肝炎的临床意义

应用单克隆抗体建立的ELISA检测各型HBV感染者179例血清IgA抗-HBc。急性乙肝14例和重肝7例均为阳性,慢活肝50例阳性率为94％,慢活肝并肝硬化12例为83.3％,慢迁肝46例为56.5％,HBsAg无症状携带者50例为4％。提示IgA抗-HBc与肝损程度和范围密切相关,在乙肝诊断、鉴别诊断及预后判断上有一定实用价值。此外,IgA抗-HBc在慢性肝炎中与HBeAg呈正相关。     

乙型肝炎病毒DNA分子杂交与临床的关系

应用病毒DNA分子杂交,Southern吸印等技术对乙肝患者33例肝内HBV-DNA进行了研究。并与血清HBV-DNA及乙肝标志做了比较。大部分患者肝内HBY-DNA呈游离型;HBeAg阳性患者25例中有13例肝内HBV-DNA阳性;6例抗HBe阳性有2例肝内HBV-DNA阳性;血清乙肝标志及HBV-DNA均为阴性者1例,肝内亦检出HBV-DNA。提示分子杂交法反映肝内HBV感染较血清学检测灵敏。通过比较肝内HBV-DNA与血清PHSA-R之间的关系,进一步证实PHSA-R做为判断乙肝病毒复制指标具有一定的可信性。     

海洛因依赖者吸毒方式与HIV及HBV、HDV、HCV、HGV感染关系研究

调查152例海洛因依赖者吸毒方式及HIV、肝炎病毒感染情况。结果显示:吸毒者中存在HIV感染。HBVM、HBsAg、HDVM、HCV、HGV感染率分别为69.74％、19.74％、2.63％、45.39％、35.53％。静脉吸毒与非静脉吸毒相比,除HBVM、HBsAg感染率无显著性差异外,其它均有显著性差异。研究认为吸毒者是4种肝炎病毒感染的高危人群,静脉吸毒方式对HCV、HGV感染较HBV感染影响更大,提示HGV感染在易感性及传播途径上与HCV更相似,而与HBV不完全相同。     

部队人群中HBV感染因素的分析

病毒性肝炎(尤其是乙型肝炎)是部队人群的常见传染病之一,查明乙型肝炎病毒(HBV)在人群中的感染状况,分析影响HBV感染的有关因素十分必要.1983年12月,我们对海军某航校进行了病毒性肝炎感染状况的流行病学调查研究,并试用单因素分析及逐步logistic回归进行多因素分析,均得到类似的结果,即影响HBV感染率在人群中分布的因素为籍贯、年龄、本人转氨酶(ALT)异常史及家庭内肝病病人接触史.经过一年半的随访观察,对部队人群HBV新感染率影响最明显的因素是集体生活小单位的乙型肝炎表面抗原(HBsAg)阳性率.经曲线拟合HBsAg阳性率(x)对HBV新感染率(y)的拟合公式为?R~2(相关指数)=0.7973.