甲、乙型肝炎病毒重复感染的血清学检测

本文分析60例甲、乙型肝炎病毒重复感染的血清学检测结果,提示重复感染占当时住院肝炎病人的14.8%。在重复感染中,同时感染甲、乙两型肝炎者9例;乙肝抗原携带者及慢性肝炎基础上感染甲肝者41例;乙肝隐性感染免疫后又感染甲肝者10例.同时观察到部分病人重复感染时,HBsAg 滴度下降或消失。并探讨了肝炎复发或突然加重的原因,认为两种肝炎病毒重复感染是肝炎复发或者突然加重的主要因素.故预防HBV 携带者及慢性乙肝重复感染其他肝炎病毒十分重要.     

乙型肝炎病毒对T细胞亚群的侵犯及对其功能的影响

以单克隆抗体补作溶解法分离T4、T8细胞亚群，PCR检测65例各型乙肝患者T细胞亚群和PBMCs中的HBVDNA，结合细胞免疫功能改变探讨HBV侵犯免疫细胞对其功能的影响。结果表明：PBMCs中HBVDNA阳性24例（24／65，36．92％），不同类型乙肝患者阳性率差异较大；T4、T8、细胞亚群中HBVDNA阳性分别为16例和21例，HBVDNA阳性组IL2R表达明显降低，抑制细胞功能有不同程度的下降；提示HBV对T8细胞可能更具亲嗜性，HBV对免疫细胞的侵犯是乙肝患者细胞免疫功能紊乱的原因之一。     

乙型肝炎病毒感染者白细胞介素2活性的改变及其与病毒复制的关系

本文采用ConA活化小鼠脾细胞~(125)I—UdR掺入法,对111例各型乙肝病毒(HBV)感染者外周血单个核细胞(PBMC)诱生的白细胞介素2(IL-2)活性进行了检测,发现:①除急性肝炎患者和无症状HBsAg携带者外,其他各型HBV感染者IL-2活性均较正常对照组显著降低(P<0.01～0.05),降低程度与临床病型有关;②病毒复制指标(HBeAg、HBV—DNA)阳性组IL-2活性显著低于阴性组(P<0.01)。结果提示IL-2活性的改变在乙型肝炎发病机理中具有重要意义。     

病毒性乙型肝炎患者粪便中HBsAg的电镜观察

病毒性乙型肝炎通过粪便进行传播,一直存在着异议.本文用免疫电镜负染法对病毒性乙型肝炎患者13份粪便进行观察,检出了HBsAg,与实验室检查结果相符。此结果不仅对病毒性乙型肝炎的流行病学有重要的意义,而且对其诊断和防治亦具有重要的理论与实际意义。     

PCR法检测乙型肝炎患者外周血单个核细胞中HBV DNA

采用ＰＣＲ法检测了７７例乙肝患者外周血单个核细胞（ＰＢＭＣ）中ＨＢＶＤＮＡ，２７例阳性，总阳性率为３５．１％。慢性活动性肝炎（９／２１，４２．９％），肝炎后肝硬化（９／１９，４７．４％）及重型肝炎（８／１６，５０．０％）患者ＰＢＭＣＨＢＶＤＮＡ阳性率明显高于慢迁肝（１／１４，７．１％）和急肝（０／７）患者。结果提示ＰＢＭＣ中ＨＢＶＤＮＡ的存在在乙肝发病机理中具有一定意义。     

THE CHANGE OF SERUM TUMOR NECROSIS FACTOR-α LEVEL AND ITS CLINICAL SIGNIFICANCE DURING THE TREATMENT OF CHRONIC HEPATITIS B WITH LAMIVUDINE

Objective To evaluate the effect of lamivudine on immunity of chronic hepatitis B by observing the sequential changes of serum TNF-α and HBV-DNA level. Methods 31 CHB patients with elevated serum ALT/AST level and HBVDNA level higher than 106 copies/mL were treated with lamivudine (100mg/day) for one year. The sequential serum samples, which were taken at the 0, 3rd, 6th, 12th month after initiation of therapy, were used to detect serum level of TNF-α and quantity of HBV-DNA respectively. Results ① The serum TNF-α levels were higher than normal value before treatment in all patients; ② At In the 3rd month of treatment, The the serum HBV-DNA level began to decline and became negative in the 54.9% of all patients. At the end of treatment, HBV-DNA was negative in 48.4% of all patients; ③ The decrease of TNF-α level was later than HBVDNA level drop. TNF-α level began to decline after 6 months treatment. At the end of treatment, TNF-α level was lower than that at in 6th month, TNF-α level returned to normal in the 38.7% of all patients; ④ The TNF-α level decreased significantly after 6 months treatment in the patients with ALT>80IU/L at the beginning of treatment. But in the patients with ALT≤80IU/L, the TNF-α level decreased just after 12 months treatment; ⑤ TNF-α level fell obviously and early in patients whose HBVDNA became negative at in the 3rd month. Conclusion Lamivudine can suppress the replication of HBVDNA quickly, and decrease TNF-α level in the serum TNF-α level. It suggests that lamivudine can modulate immune response directly or indirectly. The changes of serum TNF-α level may be used to evaluate the clinical efficacy of lamivudine.     

干扰素治疗乙型肝炎对照研究

采用精制人白细胞干扰素治疗乙型肝炎进行对照研究，结果表明，治疗组ＨＢｓＡｇ清除率（１０．５２％，４／３９），ＨＢＶＤＮＡ转阴率（４１．９３％，１３／３１）、ＨＢｅＡｇ转阴率（４５．９４％、１７／３７）明显高于对照组（３．６０％，９．９０％１６．００％），Ｐ＜０．０５，证实干扰素具有清除乙肝病毒，抑制其复制活性作用。     

SIX-YEAR EFFICACY OF HEPATITIS B REVACCINATION:A DOUBLE-BLIND,PLACEBO-CONTROLLED AND RANDOMIZED FIELD TRIAL

Alargenumberofstudiesshowedthatanti--HBsinducedbyhepatitisBvaccinedeclinedrapidlysoonafterthebasiccourseofimmunization,andfellbelowdetectablelevelorprotectivelimit(10IU/LorS/NM10)in20%~50%ofthevaccineesbetween3--5years',.,'.Forthisreason,manyresearcherssuggestedaboosterdoseduringthisperiod.Seeingthatthemajorityoftheboosterdoserecipientshadananamnesticresponsewithapromptincreaseofanti--HBs,theefficacyofrevaccinationwasconsideredtobeperfect".'>.However,thepersistenceofanti-HBsandtheprotecti…     

HIGN LEVEL EXPRESSION OF HEPATITIS C VIRUS CORE GENE IN E.COLI

Hepatitis C virus (HCV) is the major agentfor the posttransfusinal and diffusive non- A,non-B hepatitis that could transform to chronic hepati-tis,and also has close relation to liver cancer andcirrhosis[1] .HCV is a single positive- stranded RNA viruswhose genome(about9.4kilobases) contains asingle uninterrupted open reading frame (ORF )which encodes a polyprotein precursor of 30 1 0～30 1 1 amino acid residues.The genome of HCV issimilar to flavivirus and pestivirus.In vitrostudieshav…     

LONG-TERM EFFICACY AND IMMUNOLOGICAL MEMORY OF PLASMA-DERIVED HEPATITIS B VACCINE 11 YEARS AFTER INITIAL INOCULATION

The length of protection of hepatitis B vaccineand the effective time for vaccine booster doseshave not been defined.Most of studies suggestedthatthe vaccine was effective for8to1 0 years[1～ 5] .However,in most cases,the study design was notrigorous. Many were cross- sectional studies per-formed before and aftervaccination,orstudies thatcompared the vaccinees with the general popula-tion.A few of studies as by Hadler[1] et al .werebased on randomized,double- blind and placebo-controlled tria…     

小儿乙型肝炎相关性肾炎24例报告

乙型肝炎相关性肾炎,有逐年增多的趋势.本文收集1979～1984年的乙型肝炎肾炎24例,其临床表现及主要实验室资料,均支持诊断。乙型肝炎常表现为肝外损害,有时成为首发病征或综合征:如肾小球肾炎、心肌炎、关节炎、胃肠炎或血清病等。乙型肝炎肾炎也是免疫复合物性肾炎之一,其病因与慢活肝有关,与患儿的免疫功能障碍亦有关。常采用综合治疗,保护肝脏;免疫兴奋治疗,如输血或血浆,胸腺素或左旋咪唑等,均可获得较好的效果。     

DETECTION OF PLASMA SOLUBLE INTERLEUKIN－2 RECEPTOR IN PATIENTS WITH SEVERE AND CHRONIC ACTIVE HEPATITIS B

ＤＥＴＥＣＴＩＯＮＯＦＰＬＡＳＭＡＳＯＬＵＢＬＥＩＮＴＥＲＬＥＵＫＩＮ－２ＲＥＣＥＰＴＯＲＩＮＰＡＴＩＥＮＴＳＷＩＴＨＳＥＶＥＲＥＡＮＤＣＨＲＯＮＩＣＡＣＴＩＶＥＨＥＰＡＴＩＴＩＳＢＺｈａｎｇＳｈｕｌｉｎ；ＷｕＧｕａｎｇｌｉ；ＹａｎＹｕｌａｎ；Ｃｈｅ...     

NINE-YEAR EFFICACY OF HEPATITIS B VACCINATION WITHLOW-DOSE IN THE THIRD INJECTION

Nowthescheduleofvaccinationagainsthep-atitis BisusuallythreedosesoflOUg(or2oUg)',,.Itisusedasgoldstandard,asitislargelyappliedandrecommendedbyvaccinemanufactqrers.Inor-dertousethevaccinemorerationallyandtoobtainsafeimmunizationwithreducedcosts,manystud-iescompareddifferentscheduleswithvariantdosages.Buttheconclusionsdidn'tmatchwitheachother-Andfornolong-termfollowingup,theresultscan'tbeputintopractice.Inadouble-blindandrandomizedtrial,start-edinl986,weprovidedvaccineofvariantdosagesinthethir…     

ASSOCIATION OF GENETIC BACKGROUND WITH NON-ANDHYPORESPONSIVENESS TO HEPATITIS B VACCINE

ItwasestimatedthatafterthebasicimmunizationseriesofhepatitisBvaccine,about5%--10%ofthevaccinesfailedtodevelopdetectableanti--HBsorhadaminimalantibodyresponse(anti--HBsS/Nratiolessthan10),andbecameso-callednonrespondersandhyporesponders.Forthesepeoplethevaccinationwasa~.nailynoteffectiveandprotective.Accordingtothepublisheddata.thepoorresponsivenesswasrelatedtovariousfactorsandgeneticswasoneofthevariablesconcernedtl.2).However,theassociationofgeneticbackgroundwiththepoorresponsivenessstillla…     

人白细胞干扰素联合复方水飞蓟蜜丸治疗乙型慢性肝炎的疗效观察

本文报告人白细胞干扰素联合复方水飞蓟蜜丸治疗乙型慢性肝炎15例,采用小剂量(干扰素5万μ/日)长疗程(3～6个月)疗法,乙型肝炎血清标志物在15例中有10例出现有效指标,有效率达66.6%;对照组有效者5例,无效者10例,有效率33.3%,二者相比,有一定差异,但因病例少,差异不显著(P>0.05)。干扰素治疗前后曾检测血中干扰素含量,治疗前血中均测不出,治疗后3～7个月,血中干扰素量可达5～40μ/ml,停药后干扰素含量下降。用药后血中干扰素量明显增高者,疗效好,本文说明抗病毒药联合保肝药治疗乙型肝炎有一定作用,但仍需进一步观察。     

THREE－YEAR FOLLOW－UP AFTER A SINGLE BOOSTER DOSE OF VACCINE IN THE NONRESPONDERS AND HYPORESPONDERS TO HEPATITIS B VACCINE

ＴＨＲＥＥ－ＹＥＡＲＦＯＬＬＯＷ－ＵＰＡＦＴＥＲＡＳＩＮＧＬＥＢＯＯＳＴＥＲＤＯＳＥＯＦＶＡＣＣＩＮＥＩＮＴＨＥＮＯＮＲＥＳＰＯＮＤＥＲＳＡＮＤＨＹＰＯＲＥＳＰＯＮＤＥＲＳＴＯＨＥＰＡＴＩＴＩＳＢＶＡＣＣＩＮＥ（王学良）（徐慧文）（隋秀芬）（门伯媛）...     

急性散发性戊型肝炎患者血清抗体的动态检测

动态检测了34例1993年6月～1994年5月在我校附属医院住院确诊的急性散发性戊型肝炎患者血清IgM、IgG抗-HEV变化。15例患者IgM和IgG同时阳性。16例平均随访观察303d（6个月～15个月）。结果：IgM、IgG抗-HEV阳性最早出现在黄症后第3天；黄疸后10d阳性率分别达86．7％和100％。两抗体在病初1周时滴度最高，以后缓慢下降，IgM下降较快，病程2月时所检患者均降至不能检出水平；IgG抗体除1例外均在1年左右阴转。ALT在抗体出现后很快下降，6周降至近正常水平。IgM抗-HEV检出率仅44．1％，故不宜仅以此作为急性戊型肝炎诊断标准，应结合IgGJ立体动态变化，综合判断。     

酶联免疫法与放射免疫法测定血清铁蛋白含量的比较

本文报告了用酶联免疫法(EIA)及放射免疫法(RIA)对138名儿童测定血清铁蛋白含量的结果比较。结果显示,两者的相关系数为0.938(高度相关),其平均值近似,无统计学上差异。     

肾移植术后重症病毒性肝炎的病因学分析

对7例患者肾移植术后并发重症病毒性肝炎的病回进行了分析。发现所有患者均为HBSAg阳性的HBV感染者，2例重叠HCV感染，HAV和HDV重叠感染各1例。表明HBV感染及在此基础上其它肝炎病毒合并感染是发生重症肝炎的主要原因；治疗过程中环孢素A的应用和它所引起的肝肾毒性是移植后重症肝炎发生和影响患者预后的一个重要因素。提出应慎重考虑HBV感染者的肾移植适应症，有HCV、HDV重叠感染者不宜施行肾移植术。对HBsAg阳性肾移植患者应加强术后肝功能的监测，及早应用保肝药物。     

小儿HBVM与肾脏疾病

对２５５例肾脏病及５０例非肾脏病患儿分别进行ＨＢＶＭ的检测。结果显示２５５例肾脏病患儿有７１例ＨＢＶＭ阳性，阳性率为２７．８％，与对照组比较差异显著（Ｐ＜０．０１）。ＨＢＶＭ阳性率在肾炎性肾病中最高，其次是肾病综合征和原发性血尿。