CAJ | 학술논문

目的：分析云南省德宏州慢性丙型肝炎（chronic hepatitis C, CHC）患者的临床资料，了解云南省缅甸籍华裔中CHC的流行病学特征和临床特点。方法回顾性分析172例于2009年1月-2012年12月就诊于我院感染科的缅甸籍华裔和中国籍CHC患者的流行病学特点。结果①172例中男88例，女84例，年龄14～73（44.47±11.34）岁，绝大多数为缅甸籍华裔（107/172，62.21%），其中以女性（63例）和＞40岁（80例）居多，年龄大于中国籍患者（P均<0.05），职业以商人（68例）为主，感染途径以注射、输血和手术等医源性感染为主。②缅甸籍华裔患者大多无临床症状，主要通过体检发现；绝大多数患者病程＜10年；合并HIV感染率明显低于中国籍患者（7.48% vs.35.38%，P<0.001）。③缅甸籍华裔和中国籍患者基线HCV RNA水平、肝硬化发病率及病程等之间差异无统计学意义（P均>0.05）。④26例行HCV基因型检测的患者中17例为缅甸籍华裔，检测结果为3b型5例，6型4例，1b型2例，2a型1例，3a型1例，不能分出型4例。结论①缅甸籍华裔CHC患者以女性、40岁以上、商人为主，感染途径主要为医源性感染，基线HCV RNA水平、肝硬化发病率及病程与中国籍患者之间差异无统计学意义。②缅甸籍华裔患者HCV基因型呈多样化，以基因3b、6型及不能分型为主，合并HIV感染率明显低于中国籍患者。
목적：분석운남성덕굉주만성병형간염（chronic hepatitis C, CHC）환자적림상자료，료해운남성면전적화예중CHC적류행병학특정화림상특점。방법회고성분석172례우2009년1월-2012년12월취진우아원감염과적면전적화예화중국적CHC환자적류행병학특점。결과①172례중남88례，녀84례，년령14～73（44.47±11.34）세，절대다수위면전적화예（107/172，62.21%），기중이녀성（63례）화＞40세（80례）거다，년령대우중국적환자（P균<0.05），직업이상인（68례）위주，감염도경이주사、수혈화수술등의원성감염위주。②면전적화예환자대다무림상증상，주요통과체검발현；절대다수환자병정＜10년；합병HIV감염솔명현저우중국적환자（7.48% vs.35.38%，P<0.001）。③면전적화예화중국적환자기선HCV RNA수평、간경화발병솔급병정등지간차이무통계학의의（P균>0.05）。④26례행HCV기인형검측적환자중17례위면전적화예，검측결과위3b형5례，6형4례，1b형2례，2a형1례，3a형1례，불능분출형4례。결론①면전적화예CHC환자이녀성、40세이상、상인위주，감염도경주요위의원성감염，기선HCV RNA수평、간경화발병솔급병정여중국적환자지간차이무통계학의의。②면전적화예환자HCV기인형정다양화，이기인3b、6형급불능분형위주，합병HIV감염솔명현저우중국적환자。
Objective To analyze the epidemiological and clinical data of patients with chronic hepatitis C (CHC) in Dehong Prefecture, Yunnan Province, so as to investigate the epidemiological and clinical features of CHC in Chinese Burmese patients in Dehong Prefecture. Methods The epidemiological features of 172 Chinese Burmese and Chinese CHC patients treated in infectious diseases department of our hospital from Jan. 2009 to Dec. 2012 were analyzed retrospectively. Results Of 172 CHC patients, 88 were males and 84 were females. The age ranged from 14 to 73 years with a mean age of 44.47 ±11.34 years. Of all the patients, 107 were Chinese Burmese, accounting for the largest proportion (62.21%). Of Chinese Burmese patients, 63 were females, and 80 were more than 40 years old. The Chinese Burmese patients were older than the Chinese patients (P<0.05). Sixty-eight Chinese Burmese patients were merchants. The Chinese Burmese patients were mainly infected with HCV through the routes of transmission of nosocomial infection such as injections, blood transfusion and surgery. The Chinese Burmese patients were asymptomatic, and were found to be infected with HCV by making physical examination. The courses of the disease was less than 10 years. The number of the Chinese Burmese CHC patients with HIV infection was less than that of the Chinese CHC patients with HIV infection (7.48%vs. 35.38%, P<0.001). No significant differences in the baseline level of HCV RNA, the occurrence rate of liver cirrhosis and the course of the disease were found between the Chinese Burmese patients and the Chinese patients (P<0.05). Of 26 patients whose genotypes were detected, 17 were Chinese Burmese, 5 with genotype 3b, 4 with genotype 6, 2 with genotype 1b, 1 with genotype 2a, 1 with genotype 3a and 4 unable to be identified. Conclusions The Chinese Burmese CHC patients are characterized by the large proportion of females, the age older than 40 years and merchants, being infected through the routes of transmission of nosocomial infection, and no significant differences in the baseline level of HCV RNA, the occurrence rate of liver cirrhosis and the course of the disease from the Chinese patients. The genotypes of HCV in the Chinese Burmese CHC patients are diverse and are mainly genotype 3, 6 and the ones that can't be identified. The number of the Chinese Burmese patients with HCV/HIV co-infection is less than that of the Chinese patients.