摘要
目的观察输血后丙型肝炎病毒（HCV）感染者的远期预后，并分析影响其转归的危险因素。方法对87例输血后HCV感染者进行回顾性调查及随访。输血时间为1989～1995年。随访时间为11～18年，平均随访时间（14．9±1．7）年。结果①全组患者中，转变为慢性肝炎、肝硬化、肝癌者共71例，转慢性化率为81．6％。HCV—RNA阳性者61例。阳性率为85．9％；其中13例检查了HCV—RNA分型，Ib型者7例、Ⅱ型者6例，阳性率分别为53．8％和46，2％。②全组患者中，HBV的重叠感染率高达28．7％（25／87）。合并HBV感染患者转变为肝硬化者的比率（40，0％）明显高于单纯HCV感染者（14．5％）（x2=6，778，P=0．009）。③单纯HCV感染者是否发展为慢性肝病，与患者感染HCV时的年龄和性别无显著相关性，但由于男性患者乙型肝炎重叠感染的比率（39，7％）远高于女性患者（6．9％），因而全组中男性患者的慢性化率（87，9％）明显高于女性患者（68，9％）（x2=4，633，P=0．031）。④23例有饮酒嗜好者（饮酒量≥40g／d）的慢性化率（95.7％）显著高于64例无饮酒嗜好者（75．0％）（P=0，035）。⑤12例慢性丙型肝炎患者接受理干扰素、利巴韦林联合治疗12月，观察3～5年，有效率达75％。结论输血后HCV感染者慢性化率较高；合并HBV感染患者、男性患者、嗜酒是促进输血后HCV感染者疾病进展的重要危险因素；干扰素仪联合利巴韦林抗病毒治疗疗效显著。
Objective To investigate the long-term clinical outcomes of the patients with post-transfusion hepatitis C and the related risk factors affecting the outcomes. Methods Eighty-seven patients with post-transfusion hepatitis C, who received blood transfusion from 1989 to 1995, were analyzed using retrospective study and follow-up. Among them, 58 were males and 29 females. The mean age of the patients was 48.0 ± 18.4 （range, 13 to 80）, and the mean dura- tion of follow-up was （ 14.9 ± 1.7） years （ range, 11 to 18）. Results （1） Seventy-one out of the 87 patients developed into chronic hepatitis C. Cirrhosis or primary liver cancer, and the total chronicity rate was 81.6%. Among the 71 patients, 61 patients were HCV-RNA positive. And the positive rate was 85.9% ; HCV-RNA genotypes was analyzed in 13 patients, 7 patients were type Ⅰb. And 6 patients were type Ⅱ. （2） Of the 87 patients, 25 （28.7%） was accompanied with HBV infection, 40.0% of them developed into cirrhosis, which was significantly higher than that （14.5%） of those patients without HBV infection （X2 = 6. 778 ,P = 0. 009）. （3） The chronicity in the patients without HBV infection was not associated with their age of infection and gender. However, the whole chronicity rate （87.9%） in the 58 male patients was significantly higher than that of the 29 female patients （68.9%） （X2 =4. 633 ,P =0. 031 ）, due to the higher rate of HBV infection in the male patients （39.7% vs 6.9% ）. （4） The chronicity rate （95.7%） of 23 alcoholic patients was significantly higher than that （75.0%） of 64 non-alcoholic patients （ P = 0. 035 ）. （5） Twelve patients with chronic hepatitis C received a combined antiviral therapy with interferon-or and Ribavirin for 12 months. They were followed up for 3 - 5 years. The efficacy rate was 75%. Conclusion The chronicity rate of the patients with post-transfusion hepatitis C is very high. Simultaneous HBV infection, male and alcohol are important risk factors affecting
出处
《胃肠病学和肝病学杂志》
CAS
2008年第3期243-245,共3页
Chinese Journal of Gastroenterology and Hepatology
关键词
丙型肝炎
病毒性肝炎
输血
Hepatitis C
Viral hepatitis
Blood transfusion
