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[急性和慢性丙型肝炎病毒感染患者中针对各种丙型肝炎病毒抗原的抗体检测的诊断意义]

[Diagnostic significance of antibody detection to various hepatitis C virus antigens in patients with acute and chronic HCV-infection].

作者信息

Iushchuk N D, Ogienko O L, Kruglov I V, Znoĭko O O, Braginskiĭ D M, Semiletov Iu A, Finogenova M P, Alekseenkova T I, Ianina M V, Shibnev V A, Doroshenko N V

出版信息

Ter Arkh. 2002;74(4):18-22.

Abstract

AIM

To examine diagnostic value of antibodies to various HCV antigens in patients with acute and chronic HCV-infection.

MATERIAL AND METHODS

Enzyme immunoassay has tested blood sera from 136 patients with icteric acute hepatitis C (AHC) and 45 patients with chronic HCV infection for IgG antibodies to antigens of proteins core, NS4, NS5, HCV. Synthetic peptides core-16, NS4-20, NS5-23 were used as antigens.

RESULTS

Patients with icteric AHC had IgG antibodies to antigens of both structural protein core and non-structural proteins NS4, NS5 of HCV as early as the first 10 days of jaundice. Occurrence of anti-core and anti-NS4 increases with the disease duration. Incidence of anti-NS4 correlated with duration of previous intravenous drug addiction. In patients with AHC early in the icteric period anti-core, anti-NS4, anti-NS5 were present less frequently than in patients with chronic HCV infection having elevated levels of AlAT. Significant differences were found neither with the group with normal AlAt nor in the spectrum of the detected antibodies between patients with acute and chronic HCV infection.

CONCLUSION

Despite different frequency of anti-core, anti-NS4, anti-NS5 detection in patients with icteric AHC and patients with chronic HCV-infection and high AlAT, their high incidence rate in this or that group and absence of differences by the spectrum of the studied antibodies do not allow the fact of their detection to be a diagnostic marker differentiating acute HCV-infection with chronic one.

摘要

目的

检测各种丙型肝炎病毒(HCV)抗原抗体在急性和慢性HCV感染患者中的诊断价值。

材料与方法

采用酶免疫分析法检测了136例黄疸型急性丙型肝炎(AHC)患者和45例慢性HCV感染患者血清中针对核心蛋白、NS4、NS5、HCV等蛋白抗原的IgG抗体。合成肽core-16、NS4-20、NS5-23用作抗原。

结果

黄疸型AHC患者在黄疸出现的前10天就有针对HCV结构蛋白核心以及非结构蛋白NS4、NS5抗原的IgG抗体。抗核心抗体和抗NS4抗体的出现率随病程延长而增加。抗NS4抗体的发生率与既往静脉吸毒时间有关。在黄疸期早期的AHC患者中,抗核心抗体、抗NS4抗体、抗NS5抗体的出现频率低于丙氨酸转氨酶(AlAT)水平升高的慢性HCV感染患者。无论是AlAt正常的组,还是急性和慢性HCV感染患者检测到的抗体谱,均未发现显著差异。

结论

尽管黄疸型AHC患者和慢性HCV感染且AlAT升高的患者中抗核心抗体、抗NS4抗体、抗NS5抗体的检测频率不同,但它们在某一组中的高发生率以及所研究抗体谱无差异,这使得它们的检测结果不能作为区分急性HCV感染和慢性HCV感染的诊断标志物。

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