【作者】 刘三都； 程明亮； 任红； 穆茂； 杨庆坤；

【Author】 LIU San-du;CHENG Ming-liang;REN Hong;MU Mao;YANG Qing-kun;Department of Infectious Diseases,the Qiannan People’s Hospital in Guizhou Province;Department of Infectious Diseases,Affiliated Hospital of Guiyang Medical College;the Second Affiliated Hospital of Chongqing Medical University;

【机构】 贵州省黔南州人民医院感染科； 贵阳医学院附属医院感染科； 重庆医科大学附属第二医院；

【摘要】 目的:了解因输血传播HCV感染患者的临床特征及病毒自然清除率。方法:采用回顾性与横断面相结合的调查方法,对1998年1月至2002年12月期间在贵州某地接受同一位献血员血液的96例HCV感染者进行临床资料分析。对HCV感染者作抗-HCV、HCVRNA、HBV标志物、肝脏生物化学指标检测、腹部B超、肝脏弹性超声检查。使用SPSS13.0统计软件对数据进行统计学处理,计数资料用x~2检验。结果:96例受血者抗-HCV均阳性,67例符合CHC诊断标准,HCVRNA≥1.0×10~3拷贝/mL,慢性化率为6 9.7%,其中男性34例,女性33例。67例慢性丙型肝炎患者中12例有轻度乏力、纳差和腹胀,11例血清ALT升高,平均为(116.3±24.7) U/L,3例血清总胆红素轻度异常,平均为(32.6±5.3)μmol/L,肝脏弹性检测值5.1～35.3 kPa,平均值为(10.3±6.8) kPa,15例腹部B超检查显示为慢性肝炎征象,1例为肝硬化。无肝细胞癌病例。献血员及96例HCV感染者HCV基因检测均为HCV1b型。随访时间86～135月,平均随访时间为(122.6±26.5)月。HCV自然清除率为30.2%(29/96),男性为19.0%(8/42),女性为38.9%(21/54),男性明显低于女性,x~2=4.41,P=0.023,差异有统计学意义;病毒自然清除率:40岁以下年龄组为36.9%(24/65),41岁以上年龄组为16.1%(5/31),40岁以下年龄组明显高于41岁以上年龄组,x~2=4.30,P=0.028,差异有统计学意义;HCV慢性感染率,40岁以下年龄组为63.1%(41/65),41岁以上年龄组为83.9%(26/31),41岁以上年龄组明显高于40岁以下年龄组,x~2=6.67,P=0.028,差异有统计学意义。结论:输血后感染HCV患者病程经过隐匿,病毒自然清除率与性别和受感染时的年龄有关。更多还原

【Abstract】 Objective To investigate clinical features and natural viral clearance rate in patients with hepatitis C virus infection after blood transfusion.Methods 96 cases of patients with hepatitis C virus infection originating from the same blood donor from January1998 to December 2002 at some place in Guizhou were clinically investigated by retrospective plus cross-sectional survey.Meanwhile,Anti-HCV,HCVRNA,liver biochemical indicators,abdomen B ultrasound and liver elasticity value were measured.Measurement data were expressed by x±s and count data were analyzed by x~2.P <0.05 was considered statistically significant.Results Anti-HCV were all positive in 96 blood recipients.HCVRNA≥1.0 ×10~3 copies/mL in 67 patients including 34 males and 33 females.The blood donor and recipients were all HCV genotype 1 b by HCV genetic testing.Natural HCV clearance rate was 30.2%(29/96) and the rate in male which was 19.0%(8/42)was significantly lower than the rate in female which was 38.9%(21/54)(x~2=4.41,P=0.023);Virus spontaneous clearance rate in group of 40 years old below was 36.9%(24/65) and the rate in group of 41 years old above was 16.1%(5/31).There was statistical significance between different age groups(x~2=4.30,P=0.028).HCV chronic infection rate was 69.8%(67/96).The rate in group of 40 years old below was 63.1%(41/65) and the rate in group of 41 years old above was 83.9%(26/31).There was statistical significance between different age groups(x~2=6.67,P=0.028).12 patients with chronic hepatitis C had symptoms of mild weakness,anorexia and abdominal distention.11 cases of patients had elevated serum ALT(116.25±24.65 U/L) and liver elasticity values which were more than 5.1 kPa.3 cases of patients had mildly abnormal serum BIL(32.56±5.28 umol/L).Signs of chronic hepatitis were demonstrated in 15 patients and signs of cirrhosis were showed in 1 patient by abdomen B ultrasound.No hepatocellular carcinoma cases occurred.Conclusion The course of HCV infecion caused by blood transfusion is occult and natural viral clearance rate is associated with gender and age when infected.更多还原