【摘要】 目的动态追踪观察HCV感染的献血者健康状况、疾病进程和转归。方法选择刚发生HCV感染的献血者,12年中定期抽血检测,观察其HCV RNA、抗-HCV和ALT的动态变化,并按HCV RNA出现的阳性频率和转阴趋势分为两组(第1组阳性率低且趋转阴,第2组则相反),调查这些感染者的健康状况,并进行肝脾B超检查和肝组织病理检查。结果①第1组中的7名受试者血清(血浆)HCV-RNA呈间隙性阳性,阳性率为41.6%(47/113),其血清ALT异常率为14.4%(16/111),其中4名作肝活检后均诊断为轻度慢性肝炎,病理改变程度是:G1、S0和G1、S1各2例;②第2组中的19名受试者血清(血浆)HCV RNA呈持续性阳性,阳性率为88.2%(276/313),其血清ALT异常率为50.3%(159/316),其中6名肝活检也诊断为轻度慢性肝炎,但病理改变明显,G2、S2有2例,G2、S1有4例;③26名受试者一般健康状况尚佳,除部分肝脾B超呈现实质回声增强外,无其他特殊情况发现。结论26名HCV感染的献血者12年间均已发展为轻度慢性丙型肝炎;其中7名受试者病情在恢复,19名受试者病情可能有发展。更多还原

【Abstract】 Objective To follow up the dynamic changes of multiple HCV infection associated markers,disease course and health conditions of HCV-infected blood donors.Methods Blood samples from HCV-infected blood donors were collected periodically for testing.HCV RNA(PCR),anti-HCV(RIBA), anti-HCV(ELISA),and ALT(Reitman method) were measured.Liver tissue biopsies,B-ultrasound examination of the liver and spleen,physical examination,and investigation of health conditions were carried out.Results ① Seven of the 26 participants were intermittently HCV RNA positive with an HCV RNA positive rate of 41.6%(47 / 113),and an abnormal ALT rate of 14.4%(16/111).Liver tissue biopsies of 4 of the 7 participants showed mild chronic hepatitis C(2 in G1,S0,2 in G1,S1).② The remaining 19 were continuously HCV RNA positive,with an HCV RNA positive rate of 88.2%(276/313),and an abnormal ALT rate of 50.3%(159/316).Liver tissue biopsy was performed in 6 of 19 participants and all showed mild chronic hepatitis C(G2,S2,2 subjects;G2,S1,4 subjects).③Physical examination and B-ultrasonography of the 26 participants were unremarkable except enhanced liver resonance in a few cases.Conclution The 12 year follow up showed that all the 26 HCV infected blood donors were already suffering from hepatitis C.Seven of the 26 were likely in convalescence,and 19 were probably in disease progress.更多还原