抗HEV-IgA在急性戊型肝炎诊断中的意义
Significance of anti-HEV IgA detection in patients with acute HEV infection
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摘要:目的 建立酶联免疫吸附法检测血清抗HEV-IgA的方法, 了解戊型肝炎患者血清中抗HEV-IgA的动态变化规律及探讨其诊断中的意义。方法 应用北京万泰公司基因重组HEV ORF-2/ORF-3抗原预包被的酶标板, HRP标记羊抗人IgA建立检测血清抗HEV-IgA的方法。酶联免疫试验检测60例HEV RNA阳性戊型肝炎患者不同时间段血清抗HEV-IgA、抗HEV-IgM(捕获法)、抗HEV-IgG水平。结果 60例戊型肝炎患者血清抗HEV-IgA、抗HFV-IgM均为阳性, 而对照组410例非戊型肝炎病人中, 5例抗HEV-IgA阳性, 6例抗HEV-IgM, 且抗HEV-IgG和HEV RNA均阴性, 其中仅有一例出现抗HEV-IgA和HEV-IgM双阳性(隐性感染)。动态检测戊型肝炎患者血清HEV RNA、抗HEV-IgA、抗HEV-IgM和抗HEV-IgG, 发现急性戊型肝炎血清HEV RNA持续至发病后(20±11)d, 抗HEV-IgA阳性持续至(120±23)d、抗HEV-IgM阳性持续至(90±15)d, 自发病后第2个月开始, 抗HEV-IgA、抗HEV-IgM阳性率百分比差异有统计学意义(P < 0.05)。结论 戊型肝炎患者抗HEV-IgA阳性较抗HEV-IgM阳性持续时间长, 抗HEV-IgA检测弥补了抗HEV-IgM阴性急性戊型肝炎的诊断, 同时检测抗HEV-IgM和抗HEV-IgA, 可提高急性型肝炎诊断的特异性。Abstract:Objective To establish enzyme-linked immunosorbent assays of anti-HEV IgA and to investigate its clinic significance in patients with hepatitis E.Methods An enzyme-linked immunosorbent assays of anti-HEV IgA was established by instead of anti-human IgG with anti-human IgA in anti-HEV IgG assays came from Beijing WanT ai biological pharmacy enterprise. Anti-HEV IgA, anti-HEV IgM and anti-HEV IgG were detected in serial sera of 60 patients with HEV-RNA positive and control groups.Results The 60 patients with HEV-RNA positive had both anti-HEV IgA and anti-HEV IgM alone. These patients were not only negative for HEV RNA but also lack anti-HEV IgG as well. Only one patient had both anti-HEV IgA and anti-HEV IgM (covert infection). Periodic serum samples obtained from 60 patients with hepatitis E were tested for HEV RNA, anti-HEV IgA, anti -HEV IgM and anti-HEV IgG. Their HEV-RNA were detectable in the serum until 1 to 40(20±11)d. But anti-HEV IgA were detectable until 1 to 150(120±23)d, anti-HEV IgM were detectable until 1 to 150(90±15)d. After two months of the onset the positive rates of anti-HEV IgA was higher than that of anti-HEV IgM(P < 0.05).Conclusion The method to detect the antiHEV IgA is practicable. Anti-HEV IgA is longer duration than that of anti-HEV IgM and as an assistant signal to diagnose acute hepatitis E without anti-HEV IgM. Anti-HEV IgA alone or along with anti-HEV IgM is useful for serological diagnosis of hepatitis E with increased specificity.
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