抗－HEV检测对戊型病毒性肝炎诊断的意义

目的：探讨抗－ＨＥＶＩｇＧ和ＩｇＭ阳性对急性戊型肝炎（急性戊肝）的诊断价值。方法：应用酶联免疫法（ＥＬＩＳＡ）检测非肝炎住院患者血清抗－ＨＥＶＩｇＧ。结果：在３６９例非肝炎患者中，阳性３３例（８．９％），再经不同批号的试剂复测，此３３例血清仍阳性者２８例，符合率８５％，检测其抗－ＨＥＶＩｇＭ，阳性者４例。而确诊为急性戊肝的２０例患者，复检血清抗－ＨＥＶＩｇＧ阳性率仍１００％，抗－ＨＥＶＩｇＭ阳性率８０％。结论：（１）急性戊肝早期抗－ＨＥＶＩｇＧ和ＩｇＭ均可阳性。若ＩｇＭ阴性时，结合临床表现、肝功能检查、肝炎病毒感染标志检测，抗－ＨＥＶＩｇＧ阳性对急性戊肝仍有早期诊断意义；（２）在非肝炎患者或健康人中，可以出现抗－ＨＥＶＩｇＧ和ＩｇＭ阳性，前者为既往隐性感染，后者为近期隐性感染。

Significance of anti-HEV in the diagnosis of hepatitis E

To probe the value of positive anti-HEV IgG and IgM in diagnosis of acute hepatitis E. Methods: The serum anti-HEV of non-hepatitis in-patients was detected by ELISA. Results: In 33 (8. 9%) of 369 non-hepatitis patients anti-HEV IgG was positive. After retest by different batch reagents, 28 of 33 subjects showed positive anti-HEV IgG(85%), and only 4 of them positive anti-HEV IgM. In 20 patients diagnosed acute hepatitis E, the positive rate of anti-HEV IgG was 100%, that of anti-HEV IgM was 80%. Conclusion: In early stage of acute hepatitis E, both anti-HEV IgG and IgM may be positive. If IgM is negative and IgG positive, depending on clinical manifestations, liver function test and detection of infectious marker of viral hepatitis, early diagnosis of hepatitis E can be established. In healthy subjects or non-hepatitis patients, both anti-HEV IgG and IgM may be positive, the former indicates past latent infection and the latter recent latent infection.