甲型肝炎病毒微生物学及其检验课件.ppt

肝炎病毒 概念： 病毒性肝炎：一般特指由嗜肝病毒感染所引起的肝炎。 肝炎病毒：一大类能引起病毒性肝炎的病原体 病 毒 性 肝 炎 肝硬化外观 第一节 甲型肝炎病毒 甲型肝炎病毒 一 生物学特性 形态结构 球形 无包膜 单链RNA 衣壳抗原性 二 培养特性 1.动物培养 ： 静脉注射或经口---发生肝炎-----粪便（早期）、血清（恢复期） 2. 细胞培养： 病毒感染的临床检测 病毒培养及电镜检测目前在临床上均不能常规开展 ELISA法检测抗HAV-IgM是目前诊断急性甲肝最可靠、最敏感、应用最广的方法。 抗HAV-IgG检测：主要用于人群感染率的调查 也可进行PCR、核酸杂交，但也不常用 三 临床意义 粪口传播 1988年的初春，空前拥挤的医院门诊，摆满病床的工厂仓库，甚至是旅馆和学校教室，还有街头关于疫情蔓延的传闻和流言……一场突如其来的甲肝大流行，打乱了上海这座大都市的正常生活。这场疫病流行，整整持续了2个月，甲肝感染者超过35万人，死亡31人。毛蚶 口—口咽部/唾液腺（增值）—肠黏膜、局部淋巴结（大量增殖）—血液（病毒血症）—肝脏 潜伏期15—50天 转氨酶升高前5—6天 血液 粪便 发病两周 血清及肠道中产生—HAV IgG/IgM 粪便中午病毒排出 皮肤黄疸 巩膜黄染 * * 2 Before the discovery of hepatitis A virus (HAV) and hepatitis B virus (HBV) during the 1960s and 1970s, patients with viral hepatitis were classified based on epidemiological studies as having either infectious (transmitted person to person by the fecal-oral route) or serum (transmitted by transfusion of blood products) hepatitis. When diagnostic tests for HAV and HBV infections were developed, HAV was found to be the major cause of infectious hepatitis and HBV was found to be the major cause of serum hepatitis. Hepatitis delta virus (HDV), discovered in 1977, is a defective virus requiring the presence of HBV in order to replicate. However, some patients with typical signs and symptoms of viral hepatitis did not have serologic markers of HAV, HBV, or HDV infection and were categorized based on epidemiological characteristics as having either parenterally transmitted non-A, non-B (NANB) hepatitis or enterically transmitted NANB hepatitis. Subsequently, two additional viruses were discovered: hepatitis C virus (HCV) and hepatitis E virus (HEV). HCV is the major cause of parenterally transmitted NANB and HEV is the major cause of enterically transmitted NANB hepatitis. In addition, some