急性戊型肝炎血清抗-HEV IgM、IgG和HEV RNA动态变化及其诊断价值

doi:10.3969/j.issn.1672-5069.2020.06.014

实用肝脏病杂志 ›› 2020, Vol. 23 ›› Issue (6): 813-816.doi: 10.3969/j.issn.1672-5069.2020.06.014

急性戊型肝炎血清抗-HEV IgM、IgG和HEV RNA动态变化及其诊断价值

曾庆环, 孙亚男, 李鹏, 刘远志, 吴燕京, 熊峰, 武永乐, 曾阿娟, 张世斌

100069 北京市首都医科大学附属北京佑安医院肝病消化中心

收稿日期:2020-02-27 发布日期:2021-02-25
通讯作者: 张世斌,E-mail:zhangshibinyayy@163.com
作者简介:曾庆环,女,33岁,硕士研究生,医师。主要从事各种类型肝病临床诊治与研究。E-mail:zqh_9267@163.com

Dynamic changes of serum anti-HEV IgM, anti-IgG and HEV RNA in patients with acute hepatitis E

Zeng Qinghuan, Sun Yanan, Li Peng, et al

Center of Hepatic and Digestive Diseases, You'an Hospital, Capital Medical University,Beijing 100069,China

Received:2020-02-27 Published:2021-02-25

摘要/Abstract

摘要： 目的分析急性戊型肝炎(AHE)患者血清抗-HEV IgM、抗HEV-IgG和HEV RNA变化规律。方法 2016年1月～2018年3月北京佑安医院就诊的AHE患者217例,动态检测血清抗-HEV IgM、抗HEV-IgG和HEV RNA变化。结果首次检测血清抗-HEV IgM、IgG和HEV RNA均阳性31例(14.3%),抗-HEV IgM和IgG阳性99例(45.5%),抗-HEV IgM阳性8例(3.7%),抗-HEV IgG阳性72例(33.2%),抗-HEV IgM和HEV RNA均阳性3例(1.5%),抗-HEV IgG和HEV RNA均阳性2例(0.9%),抗-HEV IgM、IgG、HEV RNA均阴性2例(0.9%);在75例患者二次检测中,显示血清抗-HEV IgG阳性增多;在138例有准确的发病日期患者,在第1、2、3、4病周和第4病周后,血清HEV RNA阳性检出率分别为49.0%(25/51)、10.2%(6/59)、3.1%(1/32)、4.0%(1/25)和0.0%(0/0);血清抗-HEV IgM阳性检出率分别为70.6%(36/51)、69.5%(41/59)、65.6%(21/32)、48%(12/25)和56.5%(13/23);血清抗-HEV IgG阳性检出率分别为90.2%(46/51)、88.1%(52/59)、96.9%(31/32)、100%(25/25)和100.0%(23/23)。结论 AHE患者血清抗-HEV IgM、IgG和HEV RNA存在一定的变化规律,血清抗-HEV IgG阳性,结合典型的急性肝炎过程和排除其他病因后,可以诊断为AHE。

关键词: 戊型肝炎, 抗-HEV IgM, 抗-HEV IgG, HEV RNA

Abstract: Objective To investigate the dynamic changes of serum anti-HEV IgM, IgG and HEV RNA in patients with acute hepatitis E (AHE). Methord Serum anti-HEV IgM, IgG and HEV RNA loads were detected in a consecutive 217 patient with AHE, who were admitted to our Hospital between January 2016 and March 2018. Results At presentation,serum anti-HEV IgM, anti-HEV IgG and HEV RNA positive in 31 cases(14.3%), anti-HEV IgM and IgG positive in 99 cases (45.5%), anti-HEV IgM positive in 8 cases (3.7%), anti-HEV IgG positive in 72 cases (33.2%), anti-HEV IgM and HEV RNA positive in 3 cases (1.5%), anti-HEV IgG and HEV RNA positive in 2 cases (0.9%), and anti-HEV IgM, IgG and HEV RNA negative in 2 cases(0.9%); in 75 patients with second detection, the results showed that serum anti-HEV IgG positive increased; in 138 patients with accurate onset of the disease, serum HEV RNA positive at week one, two, three, four and after four were 49.0%(25/51), 10.2%(6/59), 3.1%(1/32), 4.0%(1/25) and 0.0%(0/0); serum anti-HEV IgM positive were 70.6%(36/51), 69.5%(41/59), 65.6%(21/32), 48%(12/25) and 56.5%(13/23); serum anti-HEV IgG positive were 90.2%(46/51), 88.1%(52/59), 96.9%(31/32), 100%(25/25) and 100.0%(23/23). Conclusion Serum anti-HEV IgM, IgG and HEV RNA changes regularly in patients with AHE, which might help clinicians to make decisions for diagnosis and management.

Key words: Hepatitis E, Anti-HEV IgM, Anti-HEV IgG, HEV RNA

曾庆环, 孙亚男, 李鹏, 刘远志, 吴燕京, 熊峰, 武永乐, 曾阿娟, 张世斌. 急性戊型肝炎血清抗-HEV IgM、IgG和HEV RNA动态变化及其诊断价值[J]. 实用肝脏病杂志, 2020, 23(6): 813-816.

Zeng Qinghuan, Sun Yanan, Li Peng, et al. Dynamic changes of serum anti-HEV IgM, anti-IgG and HEV RNA in patients with acute hepatitis E[J]. Journal of Practical Hepatology, 2020, 23(6): 813-816.

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急性戊型肝炎血清抗-HEV IgM、IgG和HEV RNA动态变化及其诊断价值

Dynamic changes of serum anti-HEV IgM, anti-IgG and HEV RNA in patients with acute hepatitis E

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