丙型肝炎病毒感染的献血者10年追踪观察  

Follow-up observation on blood donors infected with HCV for 10 years

作　　者：季阳[1] 庄文 杨翠[3] 任勤惠[1] 朱志议[1] 史宣玲[1] 彭登厚 倪声全 贾桂芳[1] 徐钢[5] 刘福荣[1] 周琼秀[1] 

机构地区：[1]中国医学科学院中国协和医科大学输血研究所,四川成都610081 [2]汕头市中心血站 [3]什邡市人民医院传染科 [4]什邡市血站 [5]四川省人民医院病理科

出　　处：《中国输血杂志》2004年第6期399-403,共5页Chinese Journal of Blood Transfusion

基　　金：美国CMB基金资助课题 (93 5 82 )

摘　　要：目的　追踪观察发生HCV感染的献血者的疾病进程和健康状况。方法　从 1993年 10月～ 2 0 0 4年 2月 ,对 30名HCV感染的献血者定期抽取血液标本 ,观察所得到的 4 4 2份系列标本的血清ALT、抗 HCV和HCV RNA的动态变化 ,并进行HCV分型测定 ,重点分析了其中 10名自愿者肝组织的病理检查结果和血清ALT、抗 HCV与HCV RNA的动态变化。结果　① 30名HCV感染者系列标本中 ,ALT异常率 37.6 % (16 6 / 4 4 2 ) ;抗 HCV阳性率97.1% (42 9/ 4 4 2 ,ELISA法 ) ;HCV RNA阳性率 74 .9% (331/ 4 4 2 )。② 10名HCV感染的献血者 10年系列血清中抗 HCV大多数持续存在 (94 4 % ,15 1/ 16 0 ) ,其HCV RNA时有间隙性阴性 ,阳性率 6 7 5 % (10 8/ 16 0 )其血清ALT水平异常率 33 6 % (5 0 / 14 9)。③HCV分型测定 :HCVⅡ / 1b型占 85 % (2 2 / 2 6 ) ,Ⅲ / 2a型占 15 % (4/ 2 6 )。④ 10名HCV感染者肝组织检查显示均为轻度慢性肝炎。结论　肝组织的病理变化同血清抗 HCV、HCV RNA和ALT的异常有明显相关性。虽然HCV感染后 10年的疾病进程大多是缓慢的 ,但应采取适当治疗措施以控制慢性肝炎的发展。Objective To follow up the disease course and health condition of blood donors infected with HCV. Methods To collect blood specimens from 30 HCV-infected subjects periodically, observe the dynamic changes of serum ALT levels, anti-HCV and HCV-RNA, perform HCV typing, liver biopsy. Results In 10 years, 442 serial sera from HCV-infected subjects were collected and analyzed, and liver biopsy was performed in 10 voluntary subjects. The results were as follows: ①The abnormal ALT rate in these HCV-infected subjects was 37.6%(166/442), demonstrating fluctuation of ALT among HCV infected persons; the anti-HCV positive rate was 97.1%(429/442); the HCV-RNA positive rate was 74.9%(331/442). ②Anti-HCV in HCV-infected blood donors' sera existed almost persistently; sometimes HCV-RNA testing in some of the HCV-infected subjects was negative; the HCV RNA positive rate was 67.5% (108/160). ③HCV typing showed that the HCV type Ⅱ/1b was 85%(22/26), and type Ⅲ/2a was 15%(4/26). ④Liver biopsies of 10 HCV-infected blood donors showed that all of them had mild chronic hepatitis. Conclusion Liver biopsies showed that all infected donors progressed to chronic hepatitis C within 10 years. The pathological changes of the liver were consistent with the detection of anti-HCV antibodies, HCV-RNA and the increased ALT levels. Although the disease progress was slow, measures needed to be taken to prevent the development of chronic hepatitis.

关 键 词：丙型肝炎病毒/感染 献血者 肝组织 

分 类 号：R512.63[医药卫生—内科学]