医学检验信息网 检验医学 2007-1-30 14:09:46

单位：510630 广州，中山医科大学附属第三医院传染科

关键词: 病毒性肝炎；转氨酶；TT病毒；病原学 【摘要】 目的 通过研究TT病毒在谷丙转氨酶升高的体检人群和肝病患者中的意义，探讨其致病性。方法 收集19例谷丙转氨酶升高体检者和41例转氨酶正常的随机对照的血清，以及182例肝病患者的血清，采用PCR方法检测TT病毒的DNA。聚合酶链反应(PCR)产物经限制性片段长度多态性(RFLP)分析验证。同时检测甲、乙、丙、戊、庚型肝炎病毒(HAV、HBV、HCV、HEV和HGV)感染标志。结果 19例转氨酶升高体检者中，TT病毒DNA检出率为10.53%(2/19)，对照组检出率为2.44%(1/41)，两者差异无显著意义(P＞0.05)。转氨酶升高者中，9例为HBV现症感染，1例为丙型肝炎，1例为甲型肝炎。2例TT病毒DNA阳性者均重叠HBV现症感染。肝病患者中TTV DNA检出比率为4.4%。18例非甲～庚型肝炎中仅1例为TTV DNA阳性。结论 在本组健康体检人群中能检出一定水平的TT病毒感染，但引起体检者转氨酶升高的主要原因为HBV感染。在肝病患者中也存在一定水平TT病毒感染，但不是非甲～庚型肝炎的主要病因。以上资料提示TT病毒的致病性可能相对较弱。 The Significance of TT Virus Detection in Persons with Elevated Alanine Aminotransferase during Routine Medical Check up and Patients with Liver Diseases

(PENG Xiaomou, GAO Zhiliang, CHEN Xuejuan, et al.

Viral Hepatitis Research Department of the 3rd Affiliated Hospital of Sun Yat-sen University of Medical Sciences, Guangzhou 510630)

【Abstract】 Objective To investigate the significance of the new DNA virus (TTV) infection in persons with elevated alanine aminotransferase (ALT) during routine medical check up and patients with liver diseases, and analyze its pathogenesis.Methods PCR was used in the detection of TTV DNA in 19 serum samples from ALT elevated persons and 41 from ALT normal persons during their routine medical check up, and 182 serum samples from patients with various kinds of liver diseases. PCR products were confirmed by RFLP. Other hepatitis viruses were simultaneously detected using routine methods.Results TTV DNA was detected in 10.53%(2/19) and 2.44%(1/41) in groups of ALT elevated and control respectively with no significant difference between their detective rates (P＞0.05). There were 9 cases with current HBV infection, 1 case with hepatitis C and 1 case with hepatitis A in group of elevated ALT. Two TTV positive cases were both superinfected with HBV. The detecting rate of TTV DNA in patients with liver diseases was 4.4%. Only one case out of 18 non A to G hepatitis showed TTV DNA in serum.Conclusion There were TTV infections in Chinese population. The main cause for ALT elevation in persons during routine medical check up was HBV infection. There were TTV infections in patients with liver diseases too. However, TTV wasn′t the main cause of non A to G hepatitis. Thus, the pathogenesis of TTV might be very weak. 【Key words】 Viral hepatitis Alanine aminotransferase TT virus Etiology Pathogenesis 自从庚型肝炎病毒(HGV)被发现以来，目前肝炎病毒已增加到了6种。然而，仍有约10%肝炎患者肝炎病毒血清标志表现为全部阴性，即所谓的非甲～庚型肝炎(Non A to G hepatitis, NA-G)^［1～4］。近来日本学者采用差式文库的分子生物学方法从1例输血后NA-G肝炎患者血清中分离出500 bp的DNA片段。并根据患者命名为TT病毒(TTV)，这种病毒似乎能引起谷丙转氨酶(ALT)轻度升高^［5，6］。在ALT升高的体检人群中也能检出TTV DNA^［7］。我们进一步采用对照形式分析TTV在ALT升高的体检人群和肝病患者中的意义，进而探讨其致病性。 1 材料和方法 1.1 病例 19例ALT升高者(＞70U/L)和41名随机抽出作对照的ALT正常人筛自1998年4月广东省玻璃厂的660名健康体检者。182例肝病患者为本院传染病科1998年5～8月的住院病人。 1.2 方法

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