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目的:探讨丙型肝炎病毒感染者血清HCV RNA含量和ALT浓度与肝脏组织病理学损伤之间的关系。方法:应用TaqMan实时荧光定量PCR技术检测681例HCV感染患者血清HCV RNA,电化学发光分析技术检测HBsAg,ELISA检测抗HAV IgM、抗HCV IgG和抗HEV IgM,Bayer全自动生化分析仪检测ALT浓度。H-E染色,光学显微镜观察组织病理损伤程度。结果:681例血清标本中,HCV RNA和抗HCV抗体均阳性和均阴性者分别是150例和420例,HCV抗体阴性而HCV RNA阳性40例,HCV RNA阴性而HCV抗体阳性71例。在排除了甲型、乙型和戊型肝炎病毒感染后,190例HCVRNA阳性患者中,36例患者在HCV RNA检测前后7 d内,曾进行过肝脏组织病理学检测,轻度、中度和重度肝脏病理学损伤患者血清中,HCV RNA浓度及ALT浓度相差均不显著。结论:血清学标志物和病毒核酸都是监测HCV感染的重要指标。HCV RNA浓度、血清ALT浓度与肝脏病理损伤相关性不显著,HCV RNA水平不能反映肝脏病理损伤程度。
Objective: To investigate the relationship between serum HCV RNA level and ALT concentration in hepatitis C virus infected patients and liver histopathological damage. Methods: HCV RNA was detected in 681 patients with HCV infection by TaqMan real-time PCR. HBsAg was detected by electrochemiluminescence assay. Anti-HAV IgM, anti-HCV IgG and anti-HEV IgM were detected by ELISA. Bayer automatic biochemical analyzer was used to detect ALT concentration . H-E staining, optical microscopy histopathological damage. Results: Among the 681 serum samples, HCV RNA and anti-HCV antibody were both positive and negative in 150 cases and 420 cases, HCV antibody negative and HCV RNA positive in 40 cases, HCV RNA negative and HCV antibody positive in 71 cases. Of the 190 HCVRNA-positive patients who had been excluded for hepatitis A, B and E infection, 36 patients had histopathological examination of liver before and after the HCV RNA test, and mild to moderate In patients with severe liver pathology, serum HCV RNA concentration and ALT concentration difference was not significant. Conclusion: Both serological markers and viral nucleic acids are important indicators of HCV infection. HCV RNA concentration, serum ALT concentration and liver pathological injury was not significant, HCV RNA levels can not reflect the degree of liver damage.