一次肠道传播性病毒性肝炎流行后的随访调查

目的武汉某校发生过一次肠道传播型肝炎流行,从粪便中检出与TT病毒同源的病毒,随访调查以了解这一新型病毒的感染过程。方法急性期和随访血清检测ALT和病毒片段。结果急性期、发病后6个月和18个月ALT增高分别为100％,29．6％和13．9％;检出病毒片段分别有77．0％,685％和18．5％。18个月时ALT正常者病毒血症也消失的80．6％;ALT增高的15例病人仅2例（133％）检出病毒,可能因此时病毒水平多低于可检出水平。结论这一病毒可长期血液携带,其血液传播的重要性,远非甲型肝炎和成型肝炎病毒所可比拟。     

An enzyme-linked immunoassay for the possible detection of non-A, non-B viral antigen in patients with epidemic viral hepatitis

An enzyme-linked immunosorbent assay has been developed by using IgM antibodies from the acute stage as a source to capture the antigen in stools of patients with epidemic non-A, non-B (NANB) viral hepatitis. 29/69 (42.3%) of the patients and 3/9 (33.3%) contacts were positive for a suspected NANB viral antigen. However, only 1/27 (3.7%) of the negative controls drawn from amongst the patients with amoebiasis, giardiasis, hepatitis due to virus A and healthy individuals was positive for NANB antigen in the stool. The suspected NANB viral antigen was more frequently detected in stools collected between the 14th and 18th day of icteric hepatitis. The study suggests that IgM antibodies from patients with acute viral NANB hepatitis react with an antigen present in the stools of a high proportion of patients with epidemic NANB viral hepatitis. This serological test may be useful to establish the etiological diagnosis of non-A, non-B (fecal-oral) viral hepatitis. ELISA-positive stools contained 27 nm viral particles.     

乙型肝炎病毒前S1抗原对判断病毒复制和乙型肝炎预后的价值

目的探讨乙型肝炎病毒前S1抗原与HBVM和HBV DNA的相关性,评价前S1抗原与病毒复制和在判断乙型肝炎预后中的作用。方法采用ELISA法检测前S1抗原;采用时间分辨免疫荧光法检测HBVM;采用酶学速率法检测肝功能;采用荧光定量PCR方法检测HBV DNA。结果在HBeAg阳性的141例患者中,HBV DNA和前S1抗原的检出率分别为97.2%和92.9%,抗-HBe阳性的183例中,分别为39.9%和37.2%;在HB-sAg阳性/抗-HBc阳性的59例中分别为62.7%和54.2%;慢性乙型肝炎轻度159例,中度132例,重度96例,其血清前S1抗原阳性率分别为56.6%、73.5%和61.5%,三组之间无显著性相差。结论检测前S1抗原可以较好地反映HBV的存在和复制,其在乙型肝炎发病中的临床意义还有待探讨。     

The 1971-72 epidemic of acute viral hepatitis in Godthaab, Greenland.

Viral hepatitis has been known to occur among the Greenland population endemically as well as in smaller and larger epidemics. A large epidemic of acute hepatitis comprising around 9% of the entire population, viz. more than 4000 notified cases, swept through Greenland between October 1970 and December 1972. 996 verified cases were seen in the Godthaab district and subjected to more detailed studies. Most of the Godthaab cases were seen among children and adolescents, and no disease was observed in children less than one year of age. Out of 996 diagnosed cases 9 showed acute hepatic failure with coma. Two further cases of hepatic coma were referred for treatment from outside the district. Three of these 11 patients recovered spontaneously. Of the residual 8 cases 6 were treated with exchange transfusions and steroids. Four of these survived and recovered completely. No lasting sequelae had been registered in any of the surviving cases of the epidemic up to June 1975 (2 1/2 years after cessation of the epidemic). Prophylaxis with gamma-globulin was undertaken in a medium-sized settlement in which practically the entire population received gamma-globulin when the first case of hepatitis was diagnosed. In this settlement only 7 out of 297 inhabitants contracted hepatitis. By contrast, in a similar settlement where no gamma-globulin was given, more than 30% of the population developed icteric hepatitis. The clinical features and the prophylactic effect of gamma-globulin seem to indicate that the epidemic was caused by the hepatitis A virus. In accordance with this, transitory Australia-antigenaemia was demonstrated in the acute phase in only 2.6% of the cases, possibly inidicating a small admixture of acute hepatitis type B to the epidemic predominantly caused by hepatitis A virus.     

乙型肝炎病毒丹氏颗粒抗原在慢性乙型肝炎病毒检测中应用的研究

目的分析乙肝病毒五项检测方法和乙肝病毒丹氏颗粒抗原检测试剂在检测慢性乙型肝炎感染中的一致性,探讨丹氏颗粒抗原检测试剂在检测慢性乙肝感染的经济性和可靠性。方法ELISA方法检测134例慢性乙肝患者的血清标志物和丹氏颗粒抗原,荧光定量PCR方法检测HBV DNA。比较各组丹氏颗粒抗原水平及HBVDNA定量水平和乙肝五项的相互关系。结果慢性乙肝患者HBsAg、HBeAg、HBcAb阳性组、HBsAg、HBcAb阳性组、HBsAg、HBeAb、HBcAb阳性组和HBsAb、HBeAb、HBcAb阳性组丹氏颗粒抗原阳性率分别为100.0(、100.0(、94.3(和0。结论丹氏颗粒抗原试剂在检测慢性乙肝感染中与乙肝五项指标及HBV DNA定量之间具有一致性。丹氏颗粒抗原是一个能较好的反应乙肝病毒复制的指标,对乙肝的诊断、预后及抗病毒疗效观察有较好的实用价值。