输血后丙型肝炎11年前瞻性研究  

11 YEARS' PROSPECTIVE STUDY ON POST-TRANSFUSION HEPATITIS C CASES

作　　者：李军[1] 孙德贵 田茶[1] 郄春力 赵玉良[1] 

机构地区：[1]河北省疾病预防控制中心,石家庄050021 [2]固安县卫生防疫站

出　　处：《现代预防医学》2007年第11期2018-2020,共3页Modern Preventive Medicine

基　　金：河北省科技厅科研项目(05360)

摘　　要：[目的]研究不同感染类型输血后丙型肝炎病人的转归。[方法]将38例输血后丙型肝炎病人分为急性黄疸型(16例)、急性无黄疸型(16例)和亚临床感染(6例)3组,采用前瞻性研究的方法,检测11年随访期间采集到的血清抗-HCV、HCVRNA和ALT。[结果]38例输血后丙型肝炎,32例为临床型,症状和体征于半年内全部消失。在11年的随访期间,所有病例均未再出现肝炎症状和体征,未发生各种晚期肝病和死亡。38例病人ALT转归存在3种类型:1,一过性异常(黄疸型︰无黄疸型︰亚临床型,6︰8︰0);2,持续异常(0︰3︰0);3,波动性异常(10︰5︰6)。38名病例均未检测到抗-HCV波动和阴转。36例病人检测两次以上HCVRNA,转归存在4种情况:1,阳转后每次检测均保持阳性26例(12︰10︰4);2,阳转后,转为阴性,再转为阳性4例(1︰2︰1);3,阳转后,再转为持续阴性5例(2︰3︰0);4,始终不能检测到HCVRNA(0︰0︰1)。不同临床型HCVRNA阴转率无差异,P﹥0.1。[结论]不同感染类型输血后丙型肝炎病人抗-HCV、HCVRNA和ALT转归相似,ALT持续异常仅见于急性无黄疸型病人,HCVRNA持续阴性仅见于亚临床型感染。[ Objective] To study the occurrence and prognosis of post-transfusion Hepatitis C cases. [ Methods] 38 post-transfusion Hepatitis C cases were divided into 3 groups according to their symptoms and physical signs of acute stage. The sera of these patients collected during 11 years were tested for anti-HCV, ALT and HCV RNA. [ Results] After acute stage, no patient presented symptom again. No death due to infection of hepatitis C was found. There were 3 types in outcome of the 38 patients： short time abnormal, persistent abnormal, and waving trend abnormal respectively. The outcome of anti-HCV just presented persistent positive. The outcome of HCV RNA included 4 types, which were persistent positive （26 cases）, waving trend （4 cases）, persistent negative after converting to positive （5 cases）, persistent positive （ 1 case） respectively. The rate that HCV RAN in serum changed to negative after converting to positive didn＇t show difference between jaundice cases and no jaundice cases （P〉 0.1） . [Conclusion] The outcome of ALT, anti-HCV and HCV RNA are similar among cases with different symptoms. Persistent negative HCV RNA is just observed in patients with no symptom. Persistent abnormal ALT just exits in acute non-jaundice patients.

关 键 词：输血 丙型肝炎 谷丙转氨酶 病毒抗体 病毒核酸 

分 类 号：R512.63[医药卫生—内科学]