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以往由于对丙型肝炎、戊型肝炎缺乏特异性诊断方法或由于现有方法不敏感,致使相当一部分肝炎患者病原不明,给治疗、预防及预后判断等带来困难。这些患者曾一度应用排除法诊断为非甲非乙型肝炎(NANBH)。随着分子生物学的发展和基因扩增技术的建立,搞清这些肝炎的病原已成为可能,因此我们对以往诊断为NANBH的患者进行回顾性病原学研究及临床分析,其结果是:(1)278份NANBH血清标本中,抗-HCV阳性率为27.4％,抗-HEV阳性率为11.7％。应用PCR法在31份HBV-M全阴的血清标本中检出HBV-DNA阳性17例,阳性率达54.8％,为什么会在HBV-M阴性者中检出HBV-DNA,其原因可能是病毒复制水平低,或机体免疫功能不全,抗原和抗体尚未达到常规法检出水平,或HBV变异引起。(2)在临床特征方面,丙肝与乙肝相似,戊肝类似甲肝,多表现为急性黄疸型肝炎。
In the past, due to lack of specific diagnosis of Hepatitis C and Hepatitis E or lack of sensitivity due to the existing methods, a considerable number of patients with hepatitis have unknown pathogeny, which brings difficulties in treatment, prevention and prognosis. These patients were once diagnosed with non-A, non-B hepatitis (NANBH) using exclusion. With the development of molecular biology and the establishment of gene amplification technology, it is possible to find out the pathogens of these hepatitis. Therefore, we retrospectively analyzed the etiological research and clinical analysis of patients previously diagnosed with NANBH. The results are as follows: (1 In 278 NANBH serum samples, the positive rate of anti-HCV was 27.4% and the positive rate of anti-HEV was 11.7%. The positive rate of HBV-DNA was detected in 31 samples of HBV-M allo-positive serum by PCR, the positive rate was 54.8%. Why HBV-DNA was detected in HBV-M-negative patients may be due to virus Low level of replication, or immune dysfunction, antigen and antibody have not yet reached the level of routine detection, or HBV mutation caused. (2) In terms of clinical features, hepatitis C is similar to hepatitis B, and hepatitis E is similar to hepatitis A, with acute jaundice hepatitis.