湖北省维持性血液透析患者丙型肝炎病毒感染调查  

Investigation on Hepatitis C Virus Infection in Patients With Maintenance Hemodialysis in Hubei Province

作　　者：韩颖[1] 熊薇[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院,武汉430030

出　　处：《内科急危重症杂志》2011年第4期208-209,222,共3页Journal of Critical Care In Internal Medicine

摘　　要：目的:调查维持性血液透析患者丙型肝炎病毒(HCV)感染情况,并探讨其相关危险因素。方法:对湖北省84所医院3608例维持性血液透析(MHD)患者,采用ELISA法检测血清标志物HCV抗体。同时调查其输血史和透析史,进行相关性分析。结果:3608例MHD患者中,HCV感染率5.88%。有输血史HCV感染率(7.12%)显著高于无输血史者(2.13%,P<0.01)。HCV阳转率透析时间小于1年为0.98%,透析1～2年为4.19%,透析2～3年为4.59%,透析3年以上为13.06%(P<0.01)。且随着每周透析次数的增加,HCV的阳转率也明显上升(P<0.05)。接受过1所医院透析的患者,HCV阳转率为3.09%,接受过2所为5.84%,接受过3所为7.44%,接受4所及以上为11.29%(P<0.01)。结论:反复输血、透析时间长、透析次数多、接受多家医院透析是MHD患者感染HCV高的重要因素。减少输血、加强透析治疗环节院内感染的质量控制对预防HCV感染有重要意义。Objective： To investigate hepatitis C virus （HCV） infection in patients with maintenance hemodialysis （MHD） and to explore its associated risk factors. Methods： Serum samples of 3 608 patients with MHD in 84 hospitals of Hubei Province were tested for anti-HCV antibodies by the method of ELISA. History of blood transfusion and hemodialysis were investigated and their correlation was analyzed. Results： The HCV infection rate was 5.88% among 3 608 patients with MHD. Infection rate （7. 12%） was much higher in patients with history of blood transfusion than those who had not （2. 13 %, P〈0. 01）. The HCV seroconversion rate was 0. 98 % for hemodialysis for less than a year, 4. 19% for 1 -2 years, 4. 59% for 2-3 years and 13. 06% for over 3 years （P 〈0. 01）. With the increasing frequency of hemodialysis per week, the rate of HCV seroconversion also increased （P 〈0. 05）. The HCV seroconversion rate was 3. 09% for hemodialysis which were carried out in one hospital, 5. 84% in 2 hospitals, 7. 44% in 3 hospitals and 11.29% in more than 4 hospitals （P〈0. 01 ）. Conclusions： Repeated blood transfusion, long period of dialysis, increasing frequency of hemodialysis as well as dialysis in multiple hospitals are the important factors of high HCV infection rate in patients with MHD. Reducing blood transfusion and strengthening the quality control of nosocomial infection in dialysis session are important for prevention of HCV infection.

关 键 词：维持性血液透析 丙型肝炎病毒 

分 类 号：R512.63[医药卫生—内科学] R318.16[医药卫生—临床医学]