Sugimoto M, Iizuka T, Sato T, Sadamoto T, Abei T, Nonaka H
Second Department of Internal Medicine, Toho University School of Medicine.
Arukoru Kenkyuto Yakubutsu Ison. 1991 Oct;26(5):349-59.
The aim of this study was to elucidate the positive rate of serum anti-HCV in alcoholic (with negative HBsAg and without blood transfusion history) and non-alcoholic (type-B and type-NANB) patients with chronic liver diseases. The clinico-pathological difference between anti-HCV positive and negative alcoholic patients was also investigated. Anti-HCV (Chiron C-100-3) was assayed with Ortho EIA kit in 196 patients. Liver function tests and the histological findings were evaluated in 111 cases of chronic hepatitis (CH) and 39 of liver cirrhosis (LC). Following results were obtained. [1] Positive rate of serum anti-HCV in alcoholic patients was 40% in CH, 36% in LC and 100% in hepatocellular carcinoma. In non-alcoholic type-NANB group, it was 75%, 68% and 69%, respectively. [2] Serum GGT/ALT ratio was higher in anti-HCV negative patients than positive patients both in CH and LC alcoholics. In non-alcoholic group, it was higher in type-NANB patients than type-B patients. [3] Among the histological findings in CH alcoholics, lymph follicles in the portal area were characteristic in anti-HCV positive patients, while these were not seen in negative patients. [4] In LC alcoholics, regenerative nodules were irregular in size in anti-HCV positive patients, while these were even and small in negative patients. [5] Serum HCV-RNA was detected in two out of 14 anti-HCV negative patients. [6] A female alcoholic patient who showed positive serum anti-HCV and negative HCV-RNA was presented. [7] For the evaluation of the influence of HCV in alcoholics, further studies have to be continued with more sensitive HCV markers.
本研究旨在阐明酒精性（乙肝表面抗原阴性且无输血史）和非酒精性（B型和非甲非乙型）慢性肝病患者血清抗丙型肝炎病毒（抗-HCV）的阳性率。同时还研究了抗-HCV阳性和阴性酒精性患者之间的临床病理差异。采用Ortho酶免疫分析试剂盒对196例患者检测抗-HCV（Chiron C-100-3）。对111例慢性肝炎（CH）和39例肝硬化（LC）患者进行了肝功能检查和组织学检查。结果如下：[1]酒精性患者血清抗-HCV阳性率在CH中为40%，在LC中为36%，在肝细胞癌中为100%。在非酒精性非甲非乙型组中，分别为75%、68%和69%。[2]在CH和LC酒精性患者中，抗-HCV阴性患者的血清谷氨酰转肽酶/谷丙转氨酶（GGT/ALT）比值高于阳性患者。在非酒精性组中，非甲非乙型患者的该比值高于B型患者。[3]在CH酒精性患者的组织学检查结果中，抗-HCV阳性患者门静脉区的淋巴滤泡具有特征性，而阴性患者未见此类滤泡。[4]在LC酒精性患者中，抗-HCV阳性患者的再生结节大小不规则，而阴性患者的再生结节均匀且小。[5]在14例抗-HCV阴性患者中有2例检测到血清丙型肝炎病毒RNA（HCV-RNA）。[6]报告了1例血清抗-HCV阳性但HCV-RNA阴性的女性酒精性患者。[7]为评估HCV对酒精性患者的影响，必须继续采用更敏感的HCV标志物进行进一步研究。
