单项抗HBc阳性的临床分析

临床上对于乙型肝炎的诊断主要是依据病人的 HBV- M结果进行判断 ,对于单项抗 HBc阳性的临床意义 ,目前有不同的争议。通过在临床工作中搜集整理的有关资料进行总结分析 ,认为单项抗 HBc阳性的意义与其在血清中的滴度有关。     

Lymphocyte T helper-specific reactivity in sustained responders to interferon and ribavirin with negativation (seroreversion) of anti-hepatitis C virus.

BACKGROUND: Seroreversion, negativation of anti-hepatitis C virus previously positive, is sometimes found in some chronic hepatitis C-sustained responders (SRs) to antiviral therapy. AIMS: To determine the probability of seroreversion in SR treatment with Interferon and Ribavirin, and lymphocyte T helper (CD4+) reactivity to HCV antigens. METHODS: Thirty SR were followed on average for 54.8 months. Anti-HCV was tested by third generation test. Peripheral blood mononuclear cells (PBMCs) were isolated from venous blood and cultured to evaluate CD4+ proliferation in response to 2 microg/ml of eight HCV recombinant antigens from core, NS3, NS4, NS5 regions. RESULTS: Seroreversion was verified in 23% of patients (7/30), appearing at 47.5+/-24.0 months. The probability of anti-HCV loss in this group was 25% at 56 months after ending therapy. In 57% (4/7), anti-HCV returned to positive. These 7 SR patients with seroreversion also showed weaker CD4+ reactivity in 5% of tests (3/56) than the remaining 23 anti-HCV-positive SRs who showed stronger reactivity in 18% of tests (33/184), P=0.036. CONCLUSIONS: One-quarter of the SR showed seroreversion of anti-HCV and weaker CD4+ specific HCV proliferation than those who remained anti-HCV positive. The data suggest that complete viral eradication is a possible and achievable clinical objective.     

Acute Renal Allograft Rejection Following Pegylated IFN-α Treatment for Chronic HCV in a Repeat Allograft Recipient on Hemodialysis: A Case Report

Interferon alpha (IFN-alpha) can be effective therapy for patients with chronic kidney disease who have chronic hepatitis C (HCV). However, acute allograft rejection has been reported in association with IFN-alpha following kidney transplantation, and therefore IFN therapy is recommended prior to, rather than after, kidney transplantation whenever feasible. The special case of repeat allograft recipients who contract HCV after the first transplantation presents special difficulties. This report features the case of a repeat allograft recipient who presented with neutropenic fevers after 5 months of pegylated IFN-alpha therapy, initiated 6 months following the functional loss of his third graft and the reinitiation of hemodialysis (HD). Physical exam, radiographic and laboratory findings led to allograft nephrectomy. The pathologic findings supported a diagnosis of acute-on-chronic rejection. This represents a rare case of IFN-alpha induced rejection following allograft failure and return to HD in a repeat allograft recipient. It also calls attention to the need for a high index of suspicion for the development of allograft rejection, which may require allograft nephrectomy even after allograft 'failure'.     

HD-91-2型肝病治疗仪治疗脂肪肝24例临床观察

[目的]探讨脂肪肝有效治疗方法。[方法]采用HD-91-2型肝病治疗仪、中药穴位透入、推按运经治疗脂肪肝24例。[结果]总有效率为91.67%。[结论]HD-91-2型肝病治疗仪作为一非药物治疗脂肪肝又一途径,是值得临床推广。     

Cutaneous, pulmonary and hepatic sarcoidosis associated with autoimmune complications during interferon-alpha treatment for hepatitis C virus infection

A patient with hepatitis C virus (HCV) infection was diagnosed with cutaneous, pulmonary and hepatic sarcoidosis following interferon alpha therapy. There are only a few cases of sarcoidosis associated with this treatment. This is the first case who not only developed sarcoidosis, but also autoimmune hypothyroidism and thrombocytopenia during interferon alpha therapy due to the immunomodulatory effects of the drug.     

静脉内毒瘾者HIV感染的转归及影响因素

对ＨＣＶ血清标记阳性的静脉内毒瘤者进行半年和１５个月随访，并调查影响转归的部分因素。结果显示，静脉内毒瘾者抗－ＨＣＶ自然转阴率分别为１１．０／和３３．３％。单因素和多因素分析均提示转阴率以婚姻状况良好的已婚者较离婚者高、人均年收入高者较低者高，说明婚姻状况和人们的经济水平对毒瘾者抗－ＨＣＶ转阴有一定的影响。     

乙型肝炎甲胎蛋白检测与重型肝炎预后指数评估的意义

给慢性活动肝炎患者输注人胎肝细胞悬液引起血清甲胎蛋白增高反应的初浓度为２０２±３８．３μｇ／Ｌ，其半衰期为１．７天；分布池为６．９一１０．２升。重型肝炎生存组血清甲胎蛋白显著高于死亡组，生存组甲胎蛋白与血清总胆红素呈非常显著相关，而死亡组两者无相关性。重型肝炎患者输注胎肝悬液后其血清甲胎蛋白进一步升高者，预后较好。取重型肝炎预后指数０．１为重型肝炎生死的截断点，判断预后的灵敏度、特异度、准确度和阳性预告值分别为７９．５％、８９．６％、８４．８％和８７．５％。重型肝炎预后指数的计算可作为判断预后与新疗法疗效的指标。     

甲乙型肝炎血清MAO同工酶活性变化研究

用荧光分光光度法检测了血清单胺氧化酶（ＭＡＯ）同工酶Ａ（ＭＡＯ－Ａ）和同工酶Ｂ（ＭＡＯ－Ｂ）活性，结果表明血清ＭＡＯ－Ｂ活性急性期甲肝组较正常对照组显著升高，慢性期乙肝极显著升高；二型肝炎组的ＭＡＯ－Ａ活性升高程度无统计学意义。二型肝炎ＭＡＯ同工酶活性改变与其它肝功生化指标无明显相关性，表现血清ＭＡＯ同工酶活性与肝功损害程度不相关。     

病毒性肝炎病人血浆VitE水平及其临床意义

观测了急性肝炎和重症肝炎病人血浆ＶｉｔＥ及Ｌｐｏ水平及其动态变化。急性肝炎和重症肝炎病人血浆ＶｉｔＥ低于对照组，Ｌｐｏ高于对照组，均以重症肝炎更明显，且死亡病例血浆ＶｉｔＥ低于存活者。部份病人口服ＶｉｔＥ不能提高其血浆水平，并随病情加重而逐渐降低。讨论了病毒性肝炎病人血浆ＶｉｔＥ降低与Ｌｐｏ升高的关系及其临床意义，认为动态观测血浆ＶｉｔＥ可作为判断重症肝炎病情进展及预后的参考。     

前列地尔注射液对慢性肝病血清透明质酸、IV型胶原、Ⅲ型前胶原的影响

目的　观察前列地尔注射液改善慢性肝病的炎症及抗肝纤维化的作用。方法　 42 5例慢性肝病随机分为治疗组 2 2 0例 ,对照组 2 0 5例 ,两组均采用相同的基础疗法。治疗组加用前列地尔 2 0ug加入 1 0 %葡萄糖 2 50ml,缓慢静脉滴注 ,每天 1次 ,1疗程结束复查透明质酸 (HA)、Ⅲ型前胶原 (PC -Ⅲ )、Ⅳ型胶原 (1V -C)、谷丙转氨酶(ALT) ,总胆红素 (TB) ,白蛋白 (A) ,球蛋白 (G)。结果　两组治疗前后比较P <0 .0 0 1 ,治疗组在降HA、PC -III、IV -C及改善肝功能方面明显优于对照组P <0 .0 0 1。结论　前列地尔对降低慢性肝病HA、PC -Ⅲ、IV -C有确切疗效