中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2009年
2期
175-178
,共4页
严艳%赵晨燕%李卓%牛京勤%阎宝山%郝娃%殷继明%王佑春
嚴豔%趙晨燕%李卓%牛京勤%閻寶山%郝娃%慇繼明%王祐春
엄염%조신연%리탁%우경근%염보산%학왜%은계명%왕우춘
肝炎,戊型%肝炎病毒,戊型%RNA,病毒%逆转录聚合酶链反应
肝炎,戊型%肝炎病毒,戊型%RNA,病毒%逆轉錄聚閤酶鏈反應
간염,무형%간염병독,무형%RNA,병독%역전록취합매련반응
Hepatitis E%Hepatitis E virus%RNA,viral%Reverse transcriptase polymerase chain reaction
目的 探讨实时荧光逆转录(RT)-PCR方法检测急性戊型肝炎患者血清戊型肝炎病毒(HEV)RNA的意义.方法 采用实时荧光RT-PCR方法,对HEV ORF3基因保守区进行扩增和检测.收集北京佑安医院住院和门诊434例急性戊型肝炎患者血清;甲型肝炎患者40例、乙型肝炎患者100例、健康献血员110名作为对照组;提取HEV RNA进行荧光RT-PCR检测.结果 434例急性戊型肝炎患者血清中232例(53.5%)为HEV RNA阳性.对照组血清HEV RNA检测均为阴性.与血清抗-HEV IgM检测比较,434例急性戊型肝炎患者HEV RNA检测的总符合率为67.1%,两种检测方法差异有统计学意义(Kappa=0.308,P=0.000).5例患者的首份血清检测为HEV RNA阳性,但抗-HEV IgM为阴性,系列追踪检测,相继出现抗-HEV IgM阳性.急性戊型肝炎患者的血清HEVRNA的检出多在发病的2～10 d内.结论 荧光RT-PCR方法有较高的特异性,应用实时荧光RT-PCR方法能对Ⅰ和Ⅳ戊型肝炎病毒感染的患者血清中的RNA进行定性检测.在临床使用可以提高对HEV早期诊断的水平.
目的 探討實時熒光逆轉錄(RT)-PCR方法檢測急性戊型肝炎患者血清戊型肝炎病毒(HEV)RNA的意義.方法 採用實時熒光RT-PCR方法,對HEV ORF3基因保守區進行擴增和檢測.收集北京祐安醫院住院和門診434例急性戊型肝炎患者血清;甲型肝炎患者40例、乙型肝炎患者100例、健康獻血員110名作為對照組;提取HEV RNA進行熒光RT-PCR檢測.結果 434例急性戊型肝炎患者血清中232例(53.5%)為HEV RNA暘性.對照組血清HEV RNA檢測均為陰性.與血清抗-HEV IgM檢測比較,434例急性戊型肝炎患者HEV RNA檢測的總符閤率為67.1%,兩種檢測方法差異有統計學意義(Kappa=0.308,P=0.000).5例患者的首份血清檢測為HEV RNA暘性,但抗-HEV IgM為陰性,繫列追蹤檢測,相繼齣現抗-HEV IgM暘性.急性戊型肝炎患者的血清HEVRNA的檢齣多在髮病的2～10 d內.結論 熒光RT-PCR方法有較高的特異性,應用實時熒光RT-PCR方法能對Ⅰ和Ⅳ戊型肝炎病毒感染的患者血清中的RNA進行定性檢測.在臨床使用可以提高對HEV早期診斷的水平.
목적 탐토실시형광역전록(RT)-PCR방법검측급성무형간염환자혈청무형간염병독(HEV)RNA적의의.방법 채용실시형광RT-PCR방법,대HEV ORF3기인보수구진행확증화검측.수집북경우안의원주원화문진434례급성무형간염환자혈청;갑형간염환자40례、을형간염환자100례、건강헌혈원110명작위대조조;제취HEV RNA진행형광RT-PCR검측.결과 434례급성무형간염환자혈청중232례(53.5%)위HEV RNA양성.대조조혈청HEV RNA검측균위음성.여혈청항-HEV IgM검측비교,434례급성무형간염환자HEV RNA검측적총부합솔위67.1%,량충검측방법차이유통계학의의(Kappa=0.308,P=0.000).5례환자적수빈혈청검측위HEV RNA양성,단항-HEV IgM위음성,계렬추종검측,상계출현항-HEV IgM양성.급성무형간염환자적혈청HEVRNA적검출다재발병적2～10 d내.결론 형광RT-PCR방법유교고적특이성,응용실시형광RT-PCR방법능대Ⅰ화Ⅳ무형간염병독감염적환자혈청중적RNA진행정성검측.재림상사용가이제고대HEV조기진단적수평.
Objective To investigate the clinical significance of detection of hepatitis E virus (HEV) RNA in sera from patients with acute hepatitis E using real-time reverse transcription (RT)-PCR to detect hepatitis E virus RNA in sera from patients with acute hepatitis E.Methods A real-time RT-PCR assay, which can amplifies and detect the conserved region on ORF3, was used in this study. 434 outpatients and hospitalized patients with acute HEV infection was enrolled into this study.Simultaneously,the serum samples from 40 patients with HAV infection, 100 patients with HBV infection and 110 healthy blood donors were collected as the control The real-time RT-PCR was performed to detect HEV RNA in all these sera.Results 232 sera (53.5%) were positive for HEV RNA by real-time RT-PCR and all of the control were negative.The results of real-time RT-PCR and anti-HEV IgM (ELISA) were concordant in 67.1% samples.There was significant difference between the two methods ( Kappa = 0.308, P = 0.000 ).The first serum sample from five serum samples of the patients was positive for HEV RNA and negative for anti-HEV IgM.Follow-up studies showed all the five sera samples were positive for anti-HEV IgM.HEV RNA in serum could be detected between 2 and 10 days.Conclusions The real-time fluorescent RT-PCR method has high specificity, and can be applied to the qualitative detection of the serum with genotypes Ⅰ and Ⅳ of hepatitis E virus.Its clinical use can improve the early diagnosis of HEV.
