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C형 간염 항체 양성 간질환에서의 B형 간염 표지자 발현상태

Other Titles
 (The) patterns of hepatitis B viral markers in liver disease patients with antiHCV positive 
Authors
 정화령 
Issue Date
1991
Description
의학과/석사
Abstract
[한글] 수혈 후 발생하는 간염의 80-9O%가 원인이 규명되지 않은 비A비B형간염이라고 생각되어 많은 연구가 이루어졌지만 최근까지 그 원인 바이러스는 분리되지 못하였다. 1989년해 Choo등은 비A비B형간염에 감염된 침팬지의 혈장으로부터 주원인이라고 생각되는 바이러스의 항원을 분리하여 이를 C형간염 바이러스로 명명하였다. 그 후 효소면역법을 이용한 C형간염 항체 검사가 용이해지자 우리 나라에서도 C형간염에 대한 연구가 활발 히 진행되고 있는데. 현재 건강한 헌혈자를 대상으로 한 C형간염 항체의 양성을 약 1% 내외로 보고되고 있다. C형간염 항체와 B형간염 표지자가 동시에 양성인 경우 간암의 발생률이 높다는 보고가 있어 한 연구에서는 간염 및 간질환의 이환율이 높은 우리 나라에서의 C형간염 항체 양성인 간질환에서 B형간염 표지자의 발현양상을 살펴보고자 하였다. 1990년 7월부터 12월까지 연세의료원을 방문한 환자들 중 간질환이 의심되는 환자들에게 효소면역법을 이용한 C형간염 항체 검사를 실시하여 양성인 환자들의 혈청을 수집하여 그 최종 진단이 간질환으로 확인된 110명을 대상으로 하였다. 그 대상군을 각 진단명별로 분류하여 B형간염 표지자의 발현양상을 알기 위하여 HBsAg, antiHB5 및 antiHBc검사를 실시하여 다음과 같은 결과를 얻었다. 1. C형간염 항체 양성인 간질환 환자들을 진단명에 따라 분류해 보면 대상군 110예 종 급성 간염이 41예 (37.3%)로 가장 많았고, 이하 간경화증 25예(23.6%), 만성 간염 18예 (16.4%), 간암 16예 (14.7%). 미분류된 만성 간질환 6예(5.5%) 및 지방간 3예 (2.7%)의 순이었다. 2. 대상군 110예 종 104예 (94.5%)가 HBsAg음성으로서 C형간염 항체 양성환자의 대부분은 HBsAg이 음성임을 알았다. 그러나 이들 107예 중 antiHBc만 양성 26예, antiHBc와 antiHBs 동시 양성 48예 등 총 74예에서는 B형간염 표지자를 1기 또는 2기의 항체 표지자는 가지고 있었다. 3. 대상군 110예 중 HasAg도 양성으로서 중복감염이 의심되는 6예 (5.5%)는 만성 간염 2 예, 간경화중 3예 및 간암 1예로 모두 만성 간질환이었다. 4. 실시한 B형간염 표지자 세가지 (HBsAg, antiHBs 밋 antiHBc) 모두 음성인 예는 대상군 110 예 중 11예 (10%)로서 급성 간염 3 예, 만성 간염 2 예, 간경화증 2 예, 간암 1예 및 미분류된 만성 간질환 3 예 등이었다. 이상의 결과를 종합하면, C형간염 항체 양성인 환자는 대부분 HBsAg음성이었으나, HBsAg도 양성으로서 중복감염이 의심되는 예는 모두 만성 간질환임을 알 수 있었다. 따라서 보다 정확한 만성 간질환 진단에는 B형간염의 유병율이 높은 우리 나라에서는 B형간염을 완전히 배제하기 위해서 뿐만 아니라 C형간염의 중복감염 여부를 확인하기 위해서도 C형간염 항체와 B형간염 표지자 검사를 동시에 시행하는 것이 필요하다는 결론을 얻었다. The patterns of Hepatitis B viral sarkers in liver dioease patients with antiHCV positive Hwa Ryung Chung Department of Medical Science, The Graduate School, Yonsei University (Directed by Professor Samuel Y. Lee. M.0.) It is well known that 80-9O% of transfusion-associated hepatitis could be attributed to non-A, non-B hepatitis (NANBH). In 1989, Choo et al. isolated a cDNA clone from a parenterally transmitted NANBH viral genome. It was named hepatitis C virus (HCV). With this genome, a polypeptide antigen (C1OO-3) is expressed and its antibody. antiHCV, can be detected by enzyme immnoassay (EIA). The seroprevalence rate of antiHCV among healthy blood donors in Korea was reported to be about l%. The previoua atudies suggested that HCV super infection in HBsAg carriers may progress in to more severe liver diseases. In this study, the correlation between antiHCV and hepatitis B viral markers was investigated. One hundred and ten patients with antiHCV-positive liver diseases were investigated for the patterns of hepatitio B viral markers who visited Yonsei Medical Center from July to December in 1990. AntiHCV was assayed with a commercially available EIA kit. The following seoul to were obtained. 1. The final diagnosis of the 110 antiHCV positive liver disease patients were composed of 41 acute hepatitis, 3 fatty liver. 26 cirrhosis, 18 chronic hepatitis, 16 hepstoma and 6 unspecified chronic liver disease etc. 2. Out of the 110 inveotigated patients, 104 (94.5%) were HBsAg negatives showing that an absolute majority of the antiHCV positive patients to be HBsAg negative. However, 74 out of these 104 were positive to either 1 or2 B hepatitis antibody markers, namely, 26 were antiHBc positive and 48 were both antiHBc and antiHBc positive. 3. Those remaining 6 (5.5%) were HBsAg positives and were all chronic liver 6disease patients, composed of 2 chronic hepatitio. 3 liver cirrhosis and one hepatoma patients. 4. Out of the 110 investigated patients, those showing no positivities against all three B hepatitis markers (HBsAg. antiHBs and antiHBc) tested were 11 (10%). composed of 3 acute hepatits. 2 chronic hepatitis. 2 liver cirrhosis, 1 hepatoma and 3 unspecified chronic 1 liver disease. Teken all these results together, it was concluded that the teats for antiHCV and hepatitis B viral markers should be included in routine assessment of patients with chronic 1 liver disease for clarifying the causative agent and their role for the diseases.
[영문] It is well known that 80-9O% of transfusion-associated hepatitis could be attributed to non-A, non-B hepatitis (NANBH). In 1989, Choo et al. isolated a cDNA clone from a parenterally transmitted NANBH viral genome. It was named hepatitis C virus (HCV). With this genome, a polypeptide antigen (C1OO-3) is expressed and its antibody. antiHCV, can be detected by enzyme immnoassay (EIA). The seroprevalence rate of antiHCV among healthy blood donors in Korea was reported to be about l%. The previoua atudies suggested that HCV super infection in HBsAg carriers may progress in to more severe liver diseases. In this study, the correlation between antiHCV and hepatitis B viral markers was investigated. One hundred and ten patients with antiHCV-positive liver diseases were investigated for the patterns of hepatitio B viral markers who visited Yonsei Medical Center from July to December in 1990. AntiHCV was assayed with a commercially available EIA kit. The following seoul to were obtained. 1. The final diagnosis of the 110 antiHCV positive liver disease patients were composed of 41 acute hepatitis, 3 fatty liver. 26 cirrhosis, 18 chronic hepatitis, 16 hepstoma and 6 unspecified chronic liver disease etc. 2. Out of the 110 inveotigated patients, 104 (94.5%) were HBsAg negatives showing that an absolute majority of the antiHCV positive patients to be HBsAg negative. However, 74 out of these 104 were positive to either 1 or2 B hepatitis antibody markers, namely, 26 were antiHBc positive and 48 were both antiHBc and antiHBc positive. 3. Those remaining 6 (5.5%) were HBsAg positives and were all chronic liver 6disease patients, composed of 2 chronic hepatitio. 3 liver cirrhosis and one hepatoma patients. 4. Out of the 110 investigated patients, those showing no positivities against all three B hepatitis markers (HBsAg. antiHBs and antiHBc) tested were 11 (10%). composed of 3 acute hepatits. 2 chronic hepatitis. 2 liver cirrhosis, 1 hepatoma and 3 unspecified chronic 1 liver disease. Teken all these results together, it was concluded that the teats for antiHCV and hepatitis B viral markers should be included in routine assessment of patients with chronic 1 liver disease for clarifying the causative agent and their role for the diseases.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/116988
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2. 학위논문 > 1. College of Medicine (의과대학) > 석사
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