Pastore G, Dentico P, Angarano G, Zanetti A R, Ferroni P, Frappampina V, Schiraldi O, Roggendorf M, Frösner G
J Med Virol. 1981;7(2):97-103. doi: 10.1002/jmv.1890070203.
The serological markers of hepatitis B virus and serum alpha-fetoprotein (AFP) levels have been studied in 28 consecutive cases of fulminant hepatitis, correlating the data with survival. On admission, 20 patients were found to be positive for HBsAg and eight for anti-HBs. All anti-HBs-positive cases showed high titers of anti-HBc, and six patients were positive for specific anti-HBc-IgM. DNA polymerase activity was detected in serum of 11 HBsAg-positive (55%) and four anti-HBs-positive (50%) patients. HBeAg was detected in six (21.4%) subjects (five HBsAg-positive and one anti-HBs-positive), whereas anti-HBe was present in nine (32.1%) subjects (six HBsAg-positive and three anti-HBs-positive). AFP levels greater than 60 ng/ml were found in sera of 14 patients (50%). No significant difference was evidenced in the survival rate between HBsAg-positive and anti-HBs-positive and between HBeAg-positive and HBe Ag-negative patients. However, a statistically significant difference (P less than 0.05) in the survival rate was found in patients positive and negative for DNA polymerase activity and in those with AFP levels higher and lower than 60 ng/ml (P less than 0.005). Pathogenetic and prognostic significance of these findings are discussed.
对28例暴发性肝炎患者连续进行了乙肝病毒血清学标志物及血清甲胎蛋白（AFP）水平的研究，并将数据与生存率相关联。入院时，发现20例患者HBsAg阳性，8例抗-HBs阳性。所有抗-HBs阳性病例均显示抗-HBc高滴度，6例患者特异性抗-HBc-IgM阳性。在11例HBsAg阳性患者（55%）和4例抗-HBs阳性患者（50%）的血清中检测到DNA聚合酶活性。6例（21.4%）受试者检测到HBeAg（5例HBsAg阳性和1例抗-HBs阳性），而9例（32.1%）受试者存在抗-HBe（6例HBsAg阳性和3例抗-HBs阳性）。14例患者（50%）血清中AFP水平大于60 ng/ml。HBsAg阳性与抗-HBs阳性患者之间以及HBeAg阳性与HBeAg阴性患者之间的生存率无显著差异。然而，DNA聚合酶活性阳性与阴性患者以及AFP水平高于和低于60 ng/ml的患者在生存率上存在统计学显著差异（P<0.05）（P<0.005）。讨论了这些发现的发病机制和预后意义。
