乙型肝炎病毒表面抗原在骨髓细胞中的存在及其与乙型肝炎病毒血清复制指标的关联

选择16例血清HBsAg阳性患者为实验组,19例血清HBsAg阴性患者为对照组,每一患者同时采取血清和骨髓涂片,用免疫细胞化学方法(PAP)检测骨髓涂片细胞中的HBsAg。结果,实验组3例骨髓细胞HBsAg阳性者,其血清中HBsAg滴度都很高,而且HBeAg均呈阳性。而在抗HBe阳性或HBeAg/HBeAb阴性者中均无骨髓细胞HBsAg阳性者。在5例血清HBV-DNA多聚酶阳性者中,骨髓细胞中HBsAg阳性者2例;6例多聚酶阴性者中,骨髓细胞中HBsAg阳性者仅1例。 本研究结果证明,HBV可在肝外组织细胞中测出,骨髓细胞HBsAg阳性的出现有集中于HBV高水平复制感染者中的倾向,同时更常见于HBV感染的较早时期。

PRESENCE OF HEPATITIS B SURFACE ANTIGEN IN BONE MARROW CELLS AND ITS ASSOCIATION WITH SERUM MARKERS OF HEPATITIS B VIRUS REPLICATION

16 cases with seropositive HBsAg were included in the experimental group.19 serum HBsAg negative patients with various hematological diseases served as control. Sera and bone marrow smears were collected from each patient simultaneously. A DAKO PAP Kit was employed to detect intracellular HBsAg. Two patterns of intracellular HBsAg distribution were observed in the positive cells, one was characterized by diffuse cytoplas-mic distribution, the other by inclusion-body-like staining. 3 of 16 patients were found to be HBsAg positive in the cytoplasm of bone marrow cells, while all of the controls were negative. Of the three positive cases, two were chronic active hepatitis and the other chronic persistent hepatitis. They had the highest serum HBsAg titer ( 1 : 2048 or more) . Moreover, we found that 2 of 4 patients with serum HBV-DNA had bone marrow cells containing HBsAg, while only 1 in 8 patients negative for HBV-DNA was found to have HBsAg in his bone marrow cells. In DNA-polymerase positive patients, 2 out of 5 had HBsAg in bone marrow cells, contrasting with 1 out of 6 from the DNA-polymerase negative patients.The results suggest that HBsAg in bone marrow cells often occur in patients with high level of systemic HBV replication.