FAS抗原与慢性丙型肝炎关系的研究

目的　通过观察慢性丙型肝炎 (CHC)患者肝组织及外周血单核细胞 (PBMC)FAS抗原表达对CHC病情的影响 ,进而探讨FAS系统及HCVRNA水平与CHC的关系及临床意义。方法　采用肝活检组织病理、免疫组织化学、PCR及血液生化等方法检测 41例CHC患者的肝组织和PBMC中FAS抗原、血清HCVRNA及肝功能 ,观察肝组织和PBMC中FAS抗原表达情况与血清HCVRNA水平及肝损伤的关系。结果　 ( 1)CHC患者PBMC的FAS阳性率为41.5 % ( 17/ 41) ,肝组织FAS阳性率为 65 .6% ( 2 1/ 3 2 )。 ( 2 )CHC患者PBMCFAS阳性组血清HCVRNA和ALT水平均显著高于FAS阴性组 (P <0 .0 5 )。结论　 ( 1)CHC患者肝组织和PBMC中FAS表达与肝组织炎症及血清病毒载量有关 ;( 2 )FAS系统可作为观察CHC病情的新指标 ,协助诊断与治疗。     

慢性丙型肝炎患者血清HCV-Cag检测及其临床意义

探讨丙型肝炎病毒核心抗原（HCV-Cag）检测在慢性丙型肝炎（CHC）诊疗中的临床应用价值。方法采用ELISA法检测血清HCV-Cag;采用FQ-PCR法检测HCV RNA。结果在262例慢性丙型肝炎患者血清中,检出HCV-Cag阳性116例（44.3%）,HCV RNA阳性112例（42.7%,P〉0.05）;两者均为阳性血清105例,均为阴性139例;不同HCV RNA载量血清HCV-Cag滴度差异有统计学意义,高病毒载量血清HCV-Cag滴度明显高于低水平血清者（P〈0.01）。结论 HCV-Cag与HCV RNA同时阳性或同时阴性的情况比较一致,在慢性丙型肝炎诊疗中,HCV-Cag检测可以作为病毒复制的指标。     

丙型肝炎患者外周血单个核细胞对特异性HCV抗原增殖反应

丙型肝炎病毒（ＨＣＶ）的发病机制和机体对ＨＣＶ的免疫应答目前尚不十分清楚。为此,我们研究了丙型肝炎（ＨＣ）患者外周血单个核细胞（ＰＢＭＣ）对ＨＣＶ特异性抗原的增殖反应,从细胞免疫的角度分析机体抗ＨＣＶ免疫功能及其与临床预后的相关性。材料与方法一、病例...     

慢性丙型肝炎患者外周血单个核细胞丙型肝炎病毒感染研究

目的 以分子生物学、免疫学有电镜等技术对慢性丙型肝炎患者ＰＢＭＣｓ进行综合检测,以证实其受ＨＣＶ感染,并试图在电镜下发现和证实感染细胞内ＨＣＶ颗粒。方法 对逆转录聚合酶链反应（ＲＴ－ＰＣＲ）和免疫组织化学等技术分别检测患者ＰＢＭＣｓ内的ＨＣＶ ＲＮＡ和ＨＣＶＡｇ,以常规和免疫电镜技术观察研究感染细胞内ＨＣＶ的形态、定位和超微结构。结果 ＨＣＶ ＲＮＡ阳性检出率为７７．２％（１７／２２）,ＨＣＶＡｇ     

慢性丙型肝炎肝组织超微结构研究

为了探究丙型肝炎超微结构形态特点，对43例慢性丙型肝炎(CH-C)肝组织作透射电镜观察。结果：多数病例的肝细胞胞浆内出现脂滴；有的线粒体显示缩小或变形，基质致密，嵴延长；内质网轻度扩张；脂褐素集聚。半数病例血窦内有淋巴细胞或单核细胞，并进入Disse隙或肝细胞间。多数病例贮脂细胞(FSC)增生，有的呈现活化现象．附近有胶原沉积。淋巴细胞与单核细胞出现率以及FSC和胶原出现率与组织学的炎症活动度和纤维化程度分别相一致。10例经干扰素治疗半年后第二次肝组织活检超微结构未见明显改变。结论：丙型肝炎肝组织之超微结构为非特异性改变，但对肝细胞损伤机制的研究和确定慢性化有一定价值。     

慢性丙型肝炎患者外周血淋巴细胞亚群的特征及临床意义

目的 探讨外周血淋巴细胞亚群在慢性丙型肝炎患者中变化的特征及其临床意义。方法 选取2018年1月至2022年7月入院诊治慢性丙型肝炎患者138例,同期健康体检者72例。根据临床表现将患者分为单纯慢性丙型肝炎组58例,丙型肝炎肝硬化失代偿组31例和丙型肝炎早期肝硬化组49例,比较患者和健康对照组临床特征、淋巴细胞计数以及多种亚群所占的百分比。结果 慢性丙型肝炎组ALT、AST和总胆红素水平分别29.6(18.2,47.8)U/L、33.6(24.4,50.1)U/L和25.5(18.5,63.6)μmol/L,显著高于对照组的21.5(16.8,26.5)U/L、23.5(15.7,30.2)U/L和16.6(13.6,26.1)μmol/L,而Hb水平为78.2(64.2,105.3)g/L,显著低于对照组的97.3(78.1,118.9)g/L,(均P<0.05)。单纯慢性丙型肝炎组CD45⁺CD3⁺CD4⁺细胞的绝对值、CD45⁺CD3⁺CD8⁺...     

慢性丙型肝炎患者淋巴细胞亚群及其凋亡研究

目的 探讨ＨＣＶ感染诱导自身免疫反应的机理。方法 应用ＥＬＩＳＡ和流式细胞术检测了１８例慢性丙型肝炎患者及１６例正常人血清丙型肝炎病毒感染相关自身抗体（抗ＧＯＲ）及抗核抗体（ＡＮＡ）、外周血淋巴细胞（ＰＢＭＣ）亚群及其凋亡百分率。结果 慢性丙型肝炎患者血清抗ＧＯＲ抗体及ＡＮＡ阳性率分别为６６．７％和４４．４％,与正常对照组比较差异均有显著意义（Ｘ＾２＝２６．８６、Ｘ＾２＝９．３０,Ｐ〈０．００５）     

慢性丙型肝炎肝组织内几种丙型肝炎病毒抗原的研究

为研究丙型肝炎病毒(HCV)不同基因编码区的抗原在慢性丙型肝炎(CH-C)时的表达情况以及它们的分布与病变的关系，应用免疫组化方法对45例临床确诊的CH-C患者肝组织内HCV-C33、NS4和CP10抗原进行检测，其中10例作了治疗前后2次穿刺比较。结果显示：3种抗原在肝组织内表达不同，它们的阳性率分别为37．8％，22．2％和53．3%。HCV抗原的表达与肝组织的炎症程度无关。虽然大多数病例HCV抗原阳性细胞的分布与组织学病变无明显关系，但也有少数患者阳性细胞分布与坏死炎症反应有关，说明免疫反应也参与了病毒对细胞的损伤。     

102例慢性丙型肝炎患者血清免疫球蛋白和补体水平变化*

目的 本研究旨在探讨102例慢性丙型肝炎患者血清免疫球蛋白（IgG、IgA、IgM）和补体（C3、C4）的变化。方法 采用胶体金法检测抗-HCV,采用实时荧光定量PCR技术检测血清HCV RNA水平,将患者分为低、中等和高病毒载量3组。结果 102例慢性丙型肝炎患者血清IgA、IgG、IgM、补体C3和C4水平分别为（3.4±1.8） g/L、（19.3±3.6） g/L、（2.7±1.3）g/L、（1.0±0.2） g/L和（0.2±0.1） g/L,除C4外,均显著高于100例正常人[分别为（2.1±0.7） g/L、（11.8±1.9） g/L、（1.1±0.5）g/L、（1.1±0.2）g/L和（0.2±0.1）g/L,P<0.05];22例低病毒载量患者血清免疫球蛋白水平显著低于64例中等和16例高病毒载量患者（P<0.05）,而高病毒载量患者血清C3和C4水平显著低于低载量和中等载量患者（P<0.05）。结论 慢性丙型肝炎患者血清免疫球蛋白和补体水平可能发生了改变,对病情和治疗判断可能具有一定的意义。     

急慢性丙型肝炎患者进行乙型肝炎病毒标志物检测的临床意义

采用ＥＩＡ、ＰＣＲ技术对急、慢性丙肝患者血清标本进行乙型肝炎病毒标志物、丙型肝炎不同功能区抗体和ＨＢＶＤＮＡ、ＨＣＶＲＮＡ检测。结果：排除甲、戊型肝炎的急、慢性丙肝的乙肝感染率的７４．６７％和５９．０９％均以ＨＢｃＡｂ和ＨＢｓＡｂ为主,其他出现,有乙肝三内肝ＡＬＴ值较高。ＨＢＶＤＮＡ检出率较低,且与ＨＣＶＲＮＡ极少同时检出;急、慢性丙肝ＨＣＶＲＮＡ检出率有乙肝旮明显偏低。有乙肝感染时急性丙肝中Ｅ     

The Relationship Between Collagen Proportionate Area and Hepatitis B Surface Antigen Levels in E Antigen Positive Hepatitis B Cirrhosis

BackgroundQuantitative serum hepatitis B surface antigen (HbsAg) has been widely used as a biomarker for treatment response and prognosis in chronic hepatitis B infection, and has recently been found associated with liver histology in e-antigen positive patients. A histological measurement as a continuous variable—collagen proportionate area (CPA)—is appropriate to assess liver fibrosis degree and substages cirrhosis. We, therefore, aimed to explore the association between serum quantitative HBsAg and CPA in e antigen-positive hepatitis B cirrhosis.MethodsLiver fibrosis staging was evaluated by METAVIR semiquantitative scoring system, only patients with METAVIR fibrosis stage 4 were included. All liver sections were stained with picroSirius red for determination of collagen quantification by digital image analysis.ResultsMean CPA value was 23.46%. The percentage of patients with different classification of CPA (<20%, 20-30%, >30%) were 25.8%, 57.8%, and 16.4%, respectively. A modest correlation was found between CPA and serum HBsAg level (r = _–0.306, P =.001). Hepatitis B surface antigen level is independently associated with CPA in multivariable linear regression analyses.ConclusionSerum HBsAg levels can predict liver fibrosis determined by CPA in HBeAg-positive hepatitis B cirrhosis.     

A Meta-Analysis of the Association Between the I148M Variant of Patatin-Like Phospholipase Domain Containing 3 Gene and the Presence of Chronic Hepatitis C

Context:

The objective of the current study was to evaluate the association between the I148M variant of patatin-like phospholipase domain-containing protein 3 (PNPLA3) and the presence of Chronic Hepatitis C (CHC) across different populations.

Evidence Acquisition:

This study was a meta-analysis of all relevant researches published in the literature from year 2000 to 2015. The odds ratios (ORs) of PNPLA3 allele distributions in CHC patients were analyzed and compared with healthy controls. The meta-analysis Revman 5.2 software was applied for investigating heterogeneity among individual studies and for summarizing all the studies. The meta-analysis was carried out according to the Cochrane Reviewers’ Handbook recommendations. A total of 120 clinical trials or reports were retrieved, yet only five trials met the study selection criteria.

Results:

Five hospital-based case-control studies were included in the final analysis. The overall frequency of PNPLA3 gene polymorphisms was 20.4% (205/1005) in CHC and 10.23% (53/518) in controls. The summary odds ratio for the association of gene polymorphisms of PNPLA3 with the risk for CHC was determined as 2.20 (95% CI: 1.56 -3.11) and was statistically significant (P < 0.05).

Conclusions:

The current meta-analysis showed an association between frequency of GG genotype of PNPLA3 and the risk of development of CHC in various populations throughout the world.     

Correlation Between Peritoneoscopic Findings and Response to Interferon in Patients with Chronic Hepatitis C

This study was designed to investigate the correlation between peritoneoscopic liver surface findings and the alanine aminotransferase (ALT) response to interferon, and to identify peritoneoscopic findings potentially useful as predictors of interferon responsiveness, in chronic hepatitis C. In all, 119 patients with hepatitis C viremia and histological evidence of chronic hepatitis received interferon alpha, in total doses of 258 to 660 million units (MU). A sustained response was seen in 29 cases (24%), a transient response with ALT relapse after therapy completion in 41 (35%) and no response in 49 (41%). Among 64 type 1 b cases, 8 (13%) showed sustained, 27 (42%) transient and 29 (45%) no response. The sustained response rate was higher with Shimada's code 200 than with code 300 or 400, even for type 1b. Interferon therapy was ineffective in more than 50% with code 300 or 400, especially in type 1b, suggesting that interferon efficacy decreases with disease progression. The sustained response rate was significantly higher, and that of no response significantly lower, in patients without reddish liver surface markings than in those with such markings (p<0.05), even in type lb. About 50% of those with reddish markings showed no response, indicating that absence of reddish markings may be a useful predictor of sustained response. The liver fibrosis score was significantly higher in the no response than in the transient and sustained response groups (p<0.02). In summary, patients with reddish liver surface markings and/or advanced fibrosis do not show a good response to interferon.     

乙、丙型肝炎病毒在慢性肝炎、肝硬化患者胃黏膜表达的临床研究

目的:探讨乙、丙型肝炎病毒(HBV、HCV)的泛嗜性.方法:选择慢性乙、丙型肝炎(慢肝组)28例、肝炎肝硬化(肝硬化组)44例,共72例作为研究对象.受检者常规胃镜检查,取胃窦幽门周围3cm以内活体组织两块,除普通病理检查外,分别做乙型肝炎病毒表面抗原(HBsAg)、乙型肝炎病毒核心抗原(HBcAg)、丙型肝炎病毒抗原(HCVAg)免疫组化法检测.结果:慢肝组有不同程度的胃黏膜慢性炎症者达92.9%(26/28)、肝硬化组达95.5%(42/44),排除年龄影响因素外,慢肝组以单纯慢性炎症为多,而肝硬化组以伴萎缩和肠化者为多.慢肝组与肝硬化组患者分别有53.6%(15/28)、81.8%(36/44)胃黏膜HBVAg阳性,其中HBsAg、HBcAg双阳性31例.在51例患者胃黏膜HCVAg检测中有33例(占64.7%)阳性表达、66.7%(22/33)与HBcAg同时表达.肝硬化组HBVAg及HBsAg、HBcAg双阳性者均高于慢肝组(P值均＜0.05).结论:HBV、HCV在慢性及肝硬化患者胃黏膜表达明显,应重视其在胃黏膜病变发病中的作用,并加强防护措施.     

The Relationship of Hepatitis B e Antigen, DNA Polymerase Activity, and Titer of Hepatitis B Surface Antigen with Ongoing Liver Injury in Chronic Hepatitis B Virus Infection

The purpose of this study was to examine the association of circulating viral markers with ongoing liver disease in chronic hepatitis B virus infection. Hepatitis B e antigen (HBeAg) was significantly more likely to be associated with abnormal alanine aminotransferase (ALT) activity than was anti-HBe in a group of 102 HBsAg carriers (p < 0.0001). Within this group, 57 carriers were analyzed for HBeAg, DNA polymerase, and hepatitis B surface antigen (HBsAg) titer, and the relation of each with abnormal ALT was determined. Both HBeAg and elevated DNA polymerase were much more likely to reflect abnormal ALT (p < 0.00001 and 0.0006, respectively) than did HBsAg titer. Unlike previous studies, higher titers of HBsAg could not be demonstrated in healthy carriers when compared to HBsAg carriers with chronic elevation of ALT; nor were differences in titer appreciated between chronic active and chronic persistent hepatitis. The potential significance of these findings is discussed.     

Fas Antigen Expression on Hepatocytes Predicts the Short- and Long-term Response to Interferon Therapy in Patients with Chronic Hepatitis C

Background: Interaction between Fas antigen on hepatocytes and Fas ligand on cytotoxic T cells induces apoptosis, a major mechanism of hepatitis C virus (HCV)-induced hepatocyte injury. We investigated the usefulness of Fas expression on hepatocytes as a predictor of short- and long-term response to interferon (IFN) therapy in 72 patients with chronic hepatitis C. Methods:     

Serum Level of Adiponectin Correlated with Gender and Genotype in Patients with Chronic Hepatitis C

Adiponectin is well recognized as plasma physiologically active polypeptide hormone exclusively derived from human and animal mature adipocytes, with vigorous property in antidiabetic, antiobesity, antiatherogenic, and anti-inflammatory processes. In this study, we investigated the correlation between serum adiponectin level and clinical and pathological parameters in patients with chronic hepatitis C (CHC). The study included 127 patients with CHC and 42 healthy volunteers as controls whose laboratory parameters and serum adiponectin and tumor necrosis factor-α (TNF-α) were assessed using enzyme-linked immunosorbent assay (ELISA). We demonstrated that a lower serum adiponectin level was associated with male gender, higher γ-glutamyltransferase (γ-GGT), higher albumin, higher TNF-α, and steatosis grade. The higher level of serum adiponectin in patients with genotype 2a was demonstrated when compared with that in the patients with genotype 1b. Furthermore, of great interest, results suggested that the significant differences regarding viral genotype seemed to occur only in male patients with CHC but not in female patients. In conclusion, serum adiponectin was associated with gender, genotype, liver steatosis, and TNF-α in a Chinese population with CHC.