CAJ | 학술논문

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、HCV RNA、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x2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,HCV RNA≥1.0×103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)μmol/L,肝脏弹性检测值5.1 ～ 35.3kPa,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HCV 1b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,x2=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,x2=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,x2=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.
목적 료해인수혈전파HCV감염환자적림상특정급병독자연청제솔. 방법 채용회고성여횡단면상결합적조사방법,대1998년1월지2002년12월재귀주모지접수동일위헌혈원혈액적96례HCV감염자진행림상자료분석.대HCV감염자작항-HCV、HCV RNA、HBV표지물、간장생물화학지표검측、복부B형초성、간장탄성초성검사.사용SPSS13.0통계연건대수거진행통계학처리,계수자료용x2검험. 결과 96례수혈자항-HCV균양성,67례부합만성병형간염진단표준,HCV RNA≥1.0×103고패/ml,만성화솔위69.7％,기중남성34례,녀성33례.67례만성병형간염환자중12례유경도핍력、납차화복창,11례혈청ALT승고,평균위(116.3±24.7)U/L,3례혈청총담홍소경도이상,평균위(32.6±5.3)μmol/L,간장탄성검측치5.1 ～ 35.3kPa,평균치위(10.3±6.8) kPa,15례복부B초검사현시위만성간염정상,1례위간경화.무간세포암병례.헌혈원급96례HCV감염자HCV기인검측균위HCV 1b형.수방시간86 ～ 135개월,평균수방시간위(122.6±26.5)개월.HCV자연청제솔위30.2％ (29/96),남성위19.0％(8/42),녀성위38.9％ (21/54),남성명현저우녀성,x2=4.41,P=0.023,차이유통계학의의;병독자연청제솔:40세이하년령조위36.9％ (24/65),41세이상년령조위16.1％ (5/31),40세이하년령조명현고우41세이상년령조,x2=4.30,P=0.028,차이유통계학의의;HCV만성감염솔,40세이하년령조위63.1％ (41/65),41세이상년령조위83.9％ (26/31),41세이상년령조명현고우40세이하년령조,x2=6.67,P=0.028,차이유통계학의의.결론 수혈후감염HCV환자병정경과은닉,병독자연청제솔여성별화수감염시적년령유관.
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 ± standard deviation.Count data were analyzed by the x2 test,with P ＜ 0.05 indicating statistical significance.Results All 96 patients tested positive for antiHCV antibodies.The majority of patients (70％; 34:33 male:female) had HCV RNA ≥ 1.0 × 103 copies/ml.All patients carried 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);x2 =4.41,P =0.023) as did older patients (＞ 40 years-old:16.1％ (5/31) vs.≤ 40 years-old:36.9％ (24/65);x2 =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);x2 =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 aminotransferase (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 by abdominal B ultrasonography.None of the patients showed signs of hepatocellular carcinoma.Conclusion The course of blood transfusion acquired HCV infection is largely unknown and natural viral clearance rate may be associated with sex-and age-related factors.