乙型肝炎患者不同时期血中HBcAb—IgM检测的临床意义

目的：通过对急性期、慢性非活动期、慢性活动期的乙型肝炎患者血中HBcAb-IgM检测，以及HBcAb—IgM与相应的肝功能和乙肝两对半进行相关分析，探讨HBcAb—IgM检测的临床意义。方法：对345例乙型肝炎病人乙肝病毒核心抗原IgM抗体用酶联试剂采用捕获法原理，两对半标志物用ELISA方法进行测定，并同时在东芝TBA-40FR全自动生化分析仪上检测相应的肝功能。结果：1．HBcAb—IgM在急性期、慢性活动期的乙型肝炎患者血中有高度的表达；2．HBcAb—IgM阳性的乙型肝炎患者与HBcA-IgM阴性的乙型肝炎患者比较，肝功能各项指标有显著差异（P〈0．01）；3．在急性期和慢性活动期，乙型肝炎患者血液中，乙肝表面抗原（HBsAg）有96．2％为阳性；在急性期，病人血液检测结果有83．3％表现为“大三阳”；在慢性活动期病人，HBcAb-IgM不仅出现在乙型肝炎病毒e抗原（HBeAg）阳性的标本中，也出现在乙型肝炎病毒e抗体（HBeAb）阳性的标本中。结论：HBcAb-IgM的血清检测对判断乙型肝炎病毒（HBV）感染状态具有较好的临床价值，是HBV早期感染的标志；也是反映HBV在体内活跃、复制的可靠指标；并可作为判断慢性乙型肝炎活动性的指标；同时可间接了解肝功能的状态以及乙肝病毒传染性强弱等情况

On Clinical Significance of HBcAb--IgM Detection in Hepatitis B Patients at Different Stages

Objective： To explore the clinical significance of HBcAb-IgM detection. Methods： HbcAb-IgM were detected by capture enzyme-linked reagent method and ＂HbsAg, HbeAg, HBc- Ab, Hbe-Ab, HBs- Ab＂ were determined by ELISA method in 345 cases of hepatitis B patients, and at the same time liver function were Detected byToshiba TBA-40FR on automatic biochemical analyzer. Results： 1. HBcAb - IgM in acute phase, chronic active hepatitis 13 patients were expressed highly; 2. The liver function between The HBcA--IgM-positive patients and The HBcAb-IgM-negative patients were significantly different （P 〈0. 01） ; 3. 96.2% HBsAg in acute and chronic active hepatitis B patients were positive; 83.3% patients in acute phase were ＂HBsAg＋, Ht3eAg＋, HBcAb＋ ＂; in chronic active patients, HBcAb-IgM were not only in HBeAg-positive specimens but also in HbeAb- positive samples. Conclusion： HBcAb-IgM are of great value to determine HBV infection also are a sign of HBV infection early and a reliable indicator of replication; and as a judge of chronic B activity indicators.