维持性血液透析患者丙型肝炎病毒感染的调查与分析  

HCV Infection in Maintenance Hemodialysis Patients:Investigation and Analysis

作　　者：吴国友[1] 庄爱周[1] 朱杰[1] 吴灵娇[2] 

机构地区：[1]浙江医院检验科,浙江杭州310013 [2]浙江大学医学院附属第一医院传染病研究所,浙江杭州310003

出　　处：《中华医院感染学杂志》2008年第12期1689-1690,共2页Chinese Journal of Nosocomiology

摘　　要：目的调查与分析维持性血液透析患者丙型肝炎病毒(HCV)的感染及其亚型的分布初步状况。方法收集210例血透患者的临床资料,采用ELISA法检测抗HCV抗体(IgM和IgG),采用RT-PCR方法检测HCV-RNA,并进一步对抗HCV抗体IgM阳性的患者进行亚型测定。结果210例血透患者中,抗HCV IgM阳性91例(43.3%),抗HCV IgG阳性87例(41.4%),HCV-RNA阳性105例(50.0%),≥1项指标阳性117例(55.7%),所有HCV指标均阳性81例(38.6%);血透患者3项HCV感染标志≥1项阳性组的肝功能指ALT、AST、LDH、-γGT显著高于3项HCV感染标志全部阴性组;91例抗HCV IgM阳性感染者中单1型55例(64.4%),2型的9例(9.8%),3型的13例(14.2%),6型的7例(7.6%),1+6型的3例(3.2%),1+3型的4例(4.3%)。结论维持性血液透析患者丙型肝炎病毒感染率较高,其中单1型感染率最高,与国外报道大概一致。OBJECTIVE To investigate the HCV infection and the distribution condition of HCV subtype in maintenance hemodialysis patients. METHODS A total of 210 cases with maintenance hemodialysis were recruited into this study. Serum samples were tested for anti-HCV antibodies using ELISA and HCV RNA by RT-PCR. At the same time, samples with anti-HCV IgM positive were identified for their subtype. RESULTS In all cases, 91 cases（43. 3%） were anti-HCV IgM positive, 87 cases（41. 4%） were anti-HCV IgG positive, and 105 cases （50.0K） were HCV-RNA positive. Nighty one cases（38.6%） were positive for all HCV infection markers, and 117 cases（55.7%） were positive for at least one marker. Compared that of cases with negative all HCV infection markers, the levels of ALT, AST, LDH and γ-GT in maintenance hemodialysis patients whose at least one marker was positive were significantly higher. Of 91 cases with positive anti-HCV IgM, 55 cases（64.4 %） were with type 1, 9 cases（9.8%） with type 2, 13 cases（14.2%） with type 3, and 7 cases（7. 6%） with type 6. In addition, 3 cases（3.2%） with types 1＋6, and 4 cases（4.3%） were with types 1＋3. CONCLUSIONS The infectious ratio of HCV in maintenance bemodialysis patients is high, particularly that of type 1 HCV is the highest.

关 键 词：维持性血液透析 丙型肝炎病毒 亚型 

分 类 号：R512.63[医药卫生—内科学]