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慢性丙型肝炎中IgM抗-HCV核心水平的意义

Significance of IgM anti-HCV core level in chronic hepatitis C.

作者信息

Papatheodoridis G V, Delladetsima J K, Katsoulidou A, Sypsa V, Albrecht M, Michel G, Hatzakis A, Tassopoulos N C

机构信息

First Department of Medicine, Western Attica General Hospital, Athens, Greece.

出版信息

J Hepatol. 1997 Jul;27(1):36-41. doi: 10.1016/s0168-8278(97)80277-2.

Abstract

AIM

To investigate the significance of IgM antibody to hepatitis C virus (HCV) core antigen (IgM anti-HCV core) in chronic hepatitis C.

METHODS

In a group of 112 patients with histologically proven chronic hepatitis C positive for HCV RNA, IgM anti-HCV core level was studied by a sensitive semi-quantitative enzyme immunoassay. Quantitation of serum HCV RNA was done by a second generation bDNA assay and determination of HCV genotype by RT-PCR and reverse hybridization.

RESULTS

IgM anti-HCV core was detected in 72 (64.3%) of the 112 patients. ALT levels were significantly higher in IgM anti-HCV core positive than negative patients. No other significant difference was observed in any of the patients' characteristics between IgM anti-HCV core positive and negative groups. On the contrary, IgM anti-HCV core level was found to be significantly higher in females than in males, in patients with moderate or severe chronic hepatitis, in patients with high HCV RNA levels and in patients infected with HCV genotype 1b. Moreover, IgM anti-HCV core level was significantly correlated with age and ALT level. Multiple regression analysis showed that IgM anti-HCV core level was significantly related only to the HCV genotype (p=0.001), histological grade (p=0.017) and ALT level (p=0.038).

CONCLUSIONS

Our data support the hypothesis that IgM anti-HCV core level is associated mainly with HCV genotype and secondly with liver disease necroinflammatory activity. These associations may have implications in the pathogenesis of chronic hepatitis C.

摘要

目的

探讨丙型肝炎病毒(HCV)核心抗原IgM抗体(IgM抗-HCV核心)在慢性丙型肝炎中的意义。

方法

在一组112例经组织学证实为HCV RNA阳性的慢性丙型肝炎患者中,采用灵敏的半定量酶免疫分析法研究IgM抗-HCV核心水平。血清HCV RNA定量采用第二代分支DNA分析法,HCV基因分型采用逆转录聚合酶链反应(RT-PCR)和反向杂交法。

结果

112例患者中有72例(64.3%)检测到IgM抗-HCV核心。IgM抗-HCV核心阳性患者的ALT水平显著高于阴性患者。在IgM抗-HCV核心阳性和阴性组之间,患者的任何特征均未观察到其他显著差异。相反,发现女性患者、中度或重度慢性肝炎患者、HCV RNA水平高的患者以及感染HCV基因1b型的患者的IgM抗-HCV核心水平显著高于男性。此外,IgM抗-HCV核心水平与年龄和ALT水平显著相关。多元回归分析显示,IgM抗-HCV核心水平仅与HCV基因型(p=0.001)、组织学分级(p=0.017)和ALT水平(p=0.038)显著相关。

结论

我们的数据支持以下假设,即IgM抗-HCV核心水平主要与HCV基因型相关,其次与肝脏疾病的坏死性炎症活动相关。这些关联可能对慢性丙型肝炎的发病机制具有重要意义。

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