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目的探讨由ＲＮＡ病毒引起的丙型肝炎（ＨＣ）、丁型肝炎（ＨＤ）和庚型肝炎（ＨＧ）的免疫病理和组织病理不同特点及临床意义。方法 采用双重ＰＡＰ方法检测ＨＣ肝组织ＨＣＶ－ＮＳ５；采用直接酶标法检测ＨＤ肝组织ＨＤＡｇ；采用链霉菌抗生物素蛋白－过氧化酶法（ＳＰ）检测ＨＧ肝组织ＨＧＶ－ＮＳ５。同时常规苏木素伊红染色。结果在免疫病理表达中，阳性信号的位置、形态和阳性肝细胞在肝小叶的分布及周围淋巴细胞的浸润等在ＨＣ、ＨＤ和ＨＧ三者中有较明显的差异。在组织病理变化中，汇管区淋巴细胞聚集或淋巴滤泡形成、胆管损伤、脂肪性变、Ｍａｌｌｏｒｙ小体、多核巨肝细胞和玫瑰花结等在 ＨＣ、ＨＤ和 ＨＧ三者中也有较明显的差异。结论ＲＮＡ病毒所引起的ＨＣ、ＨＤ和ＨＧ在免疫病理表达和组织病理变化有可鉴别诊断的不同特点，为临床防治和预后判断提供了依据。
Objective To investigate the immunopathological and histopathological features and clinical significance of hepatitis C virus (HC), hepatitis D (HD) and hepatitis G (HG) caused by RNA viruses. Methods Duplex PAP method was used to detect HCV-NS5 in HC liver tissue. HDAg of HD liver tissue was detected by direct enzyme-linked immunosorbent assay (ELISA). HGV-NS5 was detected by streptavidin-peroxidase method (SP). At the same time conventional hematoxylin eosin staining. Results In the immunopathological expression, the positive signal location, morphology and distribution of positive hepatocytes in the hepatic lobules and the infiltration of peripheral lymphocytes in the HC, HD and HG have more significant differences. Histopathological changes in the portal area lymphocyte aggregation or lymphoid follicular formation, bile duct injury, fatty changes, Mallory bodies, multinucleated giant hepatocytes and rosette in HC, HD and HG also have more obvious difference. Conclusion The different characteristics of HC, HD and HG caused by RNA virus in the differential diagnosis of immunopathology and histopathological changes provide the basis for clinical prevention and prognosis.