HBsAg对医疗操作中乙型肝炎病毒传染源的预警效果  

Predictive Effect of HBsAg to HBV Infective Source in Medical Procedures

作　　者：刘秋香[1] 姜旻岚[2] 刘瑜[2] 沈秋[1] 杨双旺[2] 

机构地区：[1]解放军第454医院护理部,南京210002 [2]解放军第454医院感控科

出　　处：《解放军护理杂志》2012年第4期72-73,76,共3页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的探讨乙型肝炎病毒表面抗原(hepatitis B surface antigen,HBsAg)对医疗操作中乙型肝炎病毒(hepatitis B virus,HBV)传染源的预警效果。方法对解放军第454医院992例连续入院的手术患者采集空腹静脉血3ml,针对HBsAg阳性和阴性HBV携带者进行传染性定量检测和分类比较。结果 992例外科患者中检出HBsAg阳性者156例。HBsAg阳性和阴性者的HBV DNA阳性率分别为73.7%和9.0%;传染性范围分别在0～1×109 ID/ml、0～1×104 ID/ml。26.3%的HBsAg阳性者HBV DNA阴性;1.0%的HBsAg阴性HBV携带者HBV浓度=1×104 ID/ml;75.6%的HBsAg阳性者HBV浓度<1×105 ID/ml,3.8%的HBsAg阳性者HBV浓度>1×107.5 ID/ml。结论以HBsAg为传染源替代指标对医疗操作中非传染源的预警效果良好,而对传染源的预警效果较差,表明HBsAg监控法预防护理人员HBV职业感染的效价比较低,实用性值得探讨。Objective To investigate the predictive effect of HBsAg to HBV infective source in medical procedures. Methods The fasting venous blood samples（3 ml） were collected in 992 consecutive surgical patients admitted to the hospital. For HBsAg positive and negative HBV carriers, the infectious quantita- tive detection and classification were conducted. Results Among 992 surgical patients, 156 cases were de- tected as HBsAg positive. HBV DNA positive ratio of HBsAg positive and negative patients are 73.7 % and 9.0% respectively,and their infectivity ranged between 0-1 × 109 ID/ml and 0-1 × 104 ID/ml. 26.3% of HBsAg positive patients were negative for HBV DNA. 1.0% of HBsAg negative HBV carriers＇ virus con- centration was 1 × 104 ID/ml; 75.6% of HBsAg positive carriers＇ HBV concentration was 〈1 × 10s ID/ml, and 3.8% was 〉1 × 107. s ID/ml. Conclusion HBsAg alternative indicators of the infection source in medi- cal procedures indicate good predictive effect of non-infectious source,and poor predictive effect of the in- fection source. The potency ratio by using HBsAg controlling measures to prevent occupational HBV infec- tion of nurses is low. Its practicability needs more investigation.

关 键 词：HBSAG HBV 医院感染 传染源 

分 类 号：R512.62[医药卫生—内科学]