非甲～非庚型肝炎病人中TTV感染和自身免疫性疾病

筛选非甲～非庚型肝炎患者血清 4 8例 ,采用冰冻组织切片间接免疫荧光法检测 4种自身抗体 :抗核抗体(ANA)、抗线粒体抗体 (AMA)、抗平滑肌抗体 (SMA)和抗肝肾微粒体抗体 (LKM) ,采用巢式PCR法检测输血传播病毒 (TTV)核酸。结果显示 ,4 8例病人中 4种自身抗体阳性总人数 2 2例 ( 45.8% ) ,其中抗 ANA阳性 1 5例 ( 31 .3% ) ,抗 AMA阳性 5例 ( 1 0 .4 % ) ,抗 SMA阳性 4例 ( 8.3% ) ,而抗 LKM未检出阳性。有 7例患者最终诊断为自身免疫性疾病 ( 3例自身免疫性肝炎 ,2例原发性胆汁性肝硬化 ,2例原发性干燥综合征 )。TTV阳性者 1 4例 ( 1 4 / 36,38.9% ) ,男女比例 2∶1 ,3例TTV感染者伴有自身抗体阳性。提示非甲～非庚型肝炎中存在自身免疫性疾病和TTV感染者 ,TTV感染导致肝损伤的过程中可以伴有自身免疫反应

TT Virus Infection and Autoimmune Diseases in Non-A, Non-G Hepatitis

All 48 screened sera were unknown etiological hepatitis. Four kinds of autoantibodies, including ANA,AMA SMA and anti-liver/kidney microsomal(LKM), were detected by indirect immuneofluorescence. TTV DNA were tested by nest PCR. Twenty-two of 48 patients(45.8%)were found with autoantibodies, 15(31.3%)with ANA, 5(10.4%)with AMA, 4(8.3%)with SMA, none with LKM. Seven of 48 patients(14.6%)were finally diagnosed as sufferering from autoimmune diseases: 3 had antoimmune hepatitis; 2 primary billiary cirrhosis and 2 primary Sjogren′s syndrome. M∶F=1∶6. Fourteen of 36(38.9%)were positive for TTV DNA. M∶F=2∶1. Three were also found to have autoantibodies in their sera. Autoimmune diseases and TTV infection prescented in Non-A, Non-G hepatitis. Severe damage in liver function could be seen in TTV patients, meanwhile autoimmune reaction was produced in some of them.