肝细胞内乙型肝炎表面抗原（HBsAg）、乙型肝炎核心抗原（HBcAg）及IgG对炎症性肝病分类的诊断意义。（对HBsAg阳性和阴性患者的研究）

The diagnostic significance of intrahepatocellular hepatitis-B-surface-antigen (HBsAg), hepatitis-B-core-antigen (HBcAg) and IgG for the classification of inflammatory liver diseases. (Studies on HBsAg-positive and -negative patients).

作者信息

Arnold W, Meyer zum Büschenfelde K H, Hess G, Knolle J

出版信息

Klin Wochenschr. 1975 Nov 15;53(22):1069-74. doi: 10.1007/BF01614383.

DOI:10.1007/BF01614383

Abstract

Liver biopsies of patients with inflammatory liver diseases and clinically healthy HBsAg-carriers were examined for presence of intracellular HBsAg, HBcAg and IgG by direct immunofluorescence. The studies revealed the following results: 1. In most cases healthy HBsAg-carriers had HBsAg in the cytoplasm, but they did never show HBcAg in the nuclei of hepatocytes. 2. In the early phase some patients with HBsAg-positive acute hepatitis had HBcAg and/or HBsAg in their hepatocytes. In a normal course with complete recovery the immunoelimination may clear either phenomenon at variable stages of the disease. 3. Cases one year after complete recovery of acute virus B-hepatitis had no HB-components in their liver tissue. 2 cases without immunoelimination of HBsAg developed chronic active hepatitis within one year and had HBcAg in their liver cell nuclei. 4. Patients with HBsAg-positive CAH and highly inflammatory activity had HBcAg in the nuclei and a low percentage of cells with HBsAg in the cytoplasm of hepatocytes. HBsAg-negative cases with CAH never had HB-components in their tissue. 5. Patients with HBsAg-positive and -negative CAH in complete remission never had HBcAg and HBsAg in their hepatocytes. 6. Most cases with HBsAg-positive acute hepatitis and chronic active hepatitis positive for HBcAg had also IgG in the same liver cell nuclei. The coincidence of this finding gives strong evidence for the presence of anti-HBc in these liver cell nuclei. The importance of this finding for the course of the disease is unknown.

摘要

通过直接免疫荧光法检查了炎症性肝病患者和临床健康的HBsAg携带者的肝活检组织中细胞内HBsAg、HBcAg和IgG的存在情况。研究结果如下：1. 在大多数情况下，健康的HBsAg携带者肝细胞胞质中有HBsAg，但肝细胞细胞核中从未出现过HBcAg。2. 在早期，一些HBsAg阳性急性肝炎患者的肝细胞中有HBcAg和/或HBsAg。在病情完全恢复的正常病程中，免疫清除可能在疾病的不同阶段清除这两种现象。3. 急性乙型肝炎完全恢复一年后的病例，其肝组织中没有HB成分。2例未清除HBsAg的患者在一年内发展为慢性活动性肝炎，其肝细胞细胞核中有HBcAg。4. HBsAg阳性且炎症活动度高的慢性活动性肝炎患者，其细胞核中有HBcAg，肝细胞胞质中含有HBsAg的细胞比例较低。HBsAg阴性的慢性活动性肝炎病例，其组织中从未有过HB成分。5. 处于完全缓解期的HBsAg阳性和阴性慢性活动性肝炎患者，其肝细胞中从未有过HBcAg和HBsAg。6. 大多数HBsAg阳性急性肝炎和HBcAg阳性慢性活动性肝炎病例，其同一肝细胞细胞核中也有IgG。这一发现的巧合有力地证明了这些肝细胞细胞核中存在抗HBc。这一发现对疾病进程的重要性尚不清楚。