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目的 :探讨戊型肝炎患者血清 HEV - RNA的动态变化及其意义。方法 :用逆转录 -巢式聚合酶链反应检测 32例戊型肝炎患者系列血清 HEV- RNA。结果 :发病后 0～ 7d,8～ 14d,15～ 2 1d,2 2～ 2 8d患者血清 HEV-RNA阳性率分别为 96 .6 % ,84.4% ,43.8%和 9.4%。病后 1周内 ,血清 HEV- RNA阳性率明显高于抗 - HEV Ig M(P <0 .0 5 )和抗 - HEV Ig G阳性率 (P <0 .0 1)。病后 2周后 ,抗 - HEV Ig M和抗 - HEV Ig G阳性率均明显高于血清HEV- RNA阳性率 (P <0 .0 1)。结论 :大部分戊型肝炎患者血清 HEV- RNA阳性持续至病后 2周 ,少部分持续至病后 3周以上。病后 1周内 ,检测血清 HEV- RNA作为早期诊断指标最敏感。但病后 2周由于血清 HEV- RNA部分阴转 ,抗 - HEV阳性率增加 ,作为诊断指标抗 - HEV比 HEV- RNA敏感。
Objective: To investigate the dynamic changes of serum HEV - RNA in patients with hepatitis E and its significance. Methods: Serum HEV-RNA of 32 patients with hepatitis E were detected by reverse transcription-nested polymerase chain reaction. Results: The positive rates of HEV-RNA in sera from 0 to 7 days, 8 to 14 days, 15 to 21 days and 22 to 28 days after onset were 96.6%, 84.4%, 43.8% and 9.4% respectively. The positive rate of HEV-RNA in serum was significantly higher than that of anti-HEV Ig M (P <0.05) and anti-HEV Ig G (P <0.01) within 1 week after disease. After 2 weeks, the positive rates of anti-HEV Ig M and anti-HEV Ig G were significantly higher than those of positive HEV-RNA (P <0.01). Conclusion: Most HEV-RNA positive in patients with hepatitis E persist to 2 weeks after the illness, and some continue until more than 3 weeks after the illness. Within 1 week after the illness, detection of serum HEV-RNA is the most sensitive indicator of early diagnosis. However, the anti-HEV positive rate was increased 2 weeks after the disease due to the partial transfection of HEV-RNA in serum, which was more sensitive than HEV-RNA as a diagnostic indicator.