论文部分内容阅读
目的了解慢性丙型病毒性肝炎(简称丙肝)患者在疾病进程中血清丙型肝炎病毒(hepatitis C vi-rus,HCV)抗体(抗-HCV)、HCV-RNA与肝功能指标的动态变化特点。方法收集46例慢性丙肝患者2～4年间系列血清588份,分别用酶联免疫吸附实验(enzyme-linked immunosorbent assay,ELISA)法测抗-HCV,荧光定量逆转录聚合酶链反应法(real-time quantitative reverse transcription polymerase chain reaction,FQ-RT-PCR)检测HCV-RNA并同步检测丙氨酸氨基转移酶(alanine amino acid transfer,ALT)、天门冬氨酸氨基转移酶(aspartic acid transaminase,AST)和胆碱脂酶(cholinesterase,CHE)等肝功能指标,对上述指标动态变化进行分析。结果慢性丙肝患者血清抗-HCV产生后长期存在,在2～4年间动态观察中,未见抗体消失现象;HCV-RNA在慢性丙肝患者血清中检出存在一过性、间歇性、持续性三种模式,以间歇性、持续性为主;588人份系列血清抗-HCV阳性率为99.49%,HCV-RNA阳性率为46.60%,两者差异存在统计学意义(2=417.71,P<0.001);ALT、AST、CHE水平在病毒复制期远高于静止期,但HCV-RNA含量高低与ALT、AST、CHE水平均不相关(均有P>0.05)。结论 HCV-RNA灵敏性较高,抗HCV指标较稳定长期存在,两者结合能提高丙肝诊断,病毒复制对肝功能有一定的影响,但HCV-RNA含量高低与ALT、AST、CHE水平无关。
Objective To investigate the dynamic changes of hepatitis C vi-rus (HCV), HCV-RNA and liver function in patients with chronic hepatitis C (HCV) during the course of the disease. Methods A total of 588 serum samples from 46 chronic hepatitis C patients were collected from 2 to 4 years. The serum levels of anti-HCV, anti-HCV and anti-HCV were detected by enzyme-linked immunosorbent assay (ELISA) (ALT) and aspartic acid transaminase (AST) were detected by real-time quantitative reverse transcription polymerase chain reaction (FQ-RT-PCR) And cholinesterase (CHE) and other liver function indicators, the dynamic changes of the above indicators were analyzed. Results Serum anti-HCV in patients with chronic hepatitis C existed for a long time. No antibody disappeared in 2 to 4 years of dynamic observation. HCV-RNA was found to be transient, intermittent and persistent in sera of patients with chronic hepatitis C The prevalence rate of anti-HCV in 588 serogroups was 99.49%, and the positive rate of HCV-RNA was 46.60%. There was a significant difference between the two groups (2 = 417.71, P < 0.001). The level of ALT, AST and CHE in virus replication was much higher than that in quiescent phase. However, the levels of HCV-RNA were not correlated with ALT, AST and CHE (all P> 0.05). Conclusion HCV-RNA has high sensitivity and long-term anti-HCV index stability. Combination of the two can improve the diagnosis of hepatitis C and the effect of virus replication on liver function. However, the level of HCV-RNA has nothing to do with the levels of ALT, AST and CHE.