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f生与横断面相结合的调查方法，对1998年1月至2002年12月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型超声、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，计数资料用石。检验。结果96例受血者抗-HCV均阳性，67例符合慢性丙型肝炎诊断标准，HCVRNA≥1．0X103拷贝／ml，慢性化率为69．7％，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）umol／L，肝脏弹性检测值5．1～35．3kPa，平均值为（10．3士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HCVlb型。随访时间86～135个月，平均随访时间为（122．6±26．5）个月。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，xk4．41，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，病毒自然清除率与眭别和受感染时的年龄有关。
Objective To investigate the clinical features and rate of natural viral clearance in patients with hepatitis C virus （HCV） infection acquired by blood transfusion from a single donor. Methods Ninety-six patients who acquired HCV infection between January 1998 and December 2002, upon receipt of donated blood from a single infected individual in Guizhou, were included in this retrospective cross-sectional study. Patients were clinically assessed to determine levels of anti-HCV antibodies, HCV RNA and biochemical indicators of liver function, as well as features of liver structure （by abdominal B ultrasonography and elastography）. HCV genetic testing was used to determine the virus genotype. Measurement data were expressed as mean -4- standard deviation. Count data were analyzed by the 23 test, with P 〈 0.05 indicating statistical significance. Results All 96 patients tested positive for anti- HCV antibodies. The majority of patients （70%; 34：33 male：female） had HCV RNA ≥ 1.0 x 103 copies/ml. All patients carded the same HCV genotype as the single blood donor： genotype lb. The overall rate of natural HCV clearance was 30.2%. but males had a significantly lower rate （19.0% （8/42） vs. females： 38.9% （21/54）;23 = 4.41,P = 0.023） as did older patients （〉 40 years-old： 16.1% （5/31） vs. ≤ 40 years-old： 36.9% （24/65）;23 = 4.30, P = 0.028）. The overall rate of chronic HCV infection （CHC） was 69.8%, but the rate was significantly lower in younger patients （ ≤ 40 years-old： 63.1% （41/65） vs. 〉 40 years-old： 83.9% （26/31）;23 = 6.67,P= 0.028）. Among the 67 patients with CHC, 12 had symptoms of mild weakness, anorexia and abdominal distention, 11 had elevated serum alanine aminotrsnsferase （116.25.± 24.65 U/L） and stage 3 or 4 fibrosis （liver elasticity values ≥ 5.1 kPa）, and three had mildly abnormal serum bilirubin （32.56 ± 5.28 μmol/L）. Fifteen patients showed signs of chronic hepatitis and one patient showed signs of cirrhosis b
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2014年第4期251-254,共4页
Chinese Journal of Hepatology
基金
贵州省省长资金西因临床重点应用课题项目（2012[124]-31号）
关键词
肝炎病毒
丙型
肝炎
丙型
慢性
输血
病毒自然清除
Hepatitis C virus
Hepatitis C, chronic
Blood transfusion
Natural viral clearance
