有偿献血人群血浆雌二醇与HCV感染及肝功能情况关系的研究  

Study on associations of plasma estradiol level with HCV infection and liver function in paid blood donors

作　　者：唐筛娣[1] 王佳佳[1] 王洁[1] 许可[2] 唐玲燕[1] 喻荣彬[1] 张云[1,3] 

机构地区：[1]南京医科大学公共卫生学院流行病与卫生统计学系,江苏南京210029 [2]江苏省疾病预防控制中心急性传染病防治所,江苏南京210009 [3]南京军区军事医学研究所流行病与微生物研究所,江苏南京210002

出　　处：《中华疾病控制杂志》2013年第7期553-556,共4页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金(81102165)

摘　　要：目的分析有偿献血人群血浆雌二醇(estradiol,E2)水平与丙型肝炎病毒(hepatitis C virus,HCV)感染情况及肝功能指标的关系,为HCV感染转归的致病机理及其预防提供参考依据。方法以江苏省某县级市于1990年前后曾发生有偿献血行为的男性和大于50岁以上的女性为研究对象,共收集样本195例,其中健康对照组56例,自限清除组44例和持续感染组95例。通过检测3组人群的E2和肝功能指标包括丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、总胆红素(total bilirubin,Tbil)、直接胆红素(direct bilirubin,Dbil)、谷酰转肽酶(gamma-glu-tamyl transpeptidase,GGT)、碱性磷酸酶(alkaline phosphatase,ALP)的浓度,分析它们与HCV感染转归及相互之间的关系。结果以献全血次数、单采血浆次数和脂肪肝和/或肝硬化为协变量,3组间的ALT(P=0.003)和AST(P=0.025)水平差异均有统计学意义;E2与ALT、AST、GGT和ALP呈弱的负相关,但差异均无统计学意义(均有P>0.05)。多因素Logistic回归分析结果显示,年龄增长是慢性HCV感染者血清ALT升高的独立危险因素(OR=1.122,95%CI:1.036～1.215)。结论为预防HCV感染的发生,应加强并规范采供血的管理,而连续的大样本的随访研究有助于进一步探讨血浆E2水平对HCV感染转归及肝功能的影响作用。Objective To explore the associations of plasma estradiol （ E2 ） level with HCV infection and liver function in paid blood donors, and to provide evidence for the pathogenesis and prevention measures of HCV infection. Methods The study population were consisted of 195 subjects （59 males and 136 females over 50-year old） who were paid blood donors from a certain city in Jiangsu province around 1990. All subjects were categorized into three groups, including 95 persistent HCV carriers, 44 HCV natural clearance subjects, and 56 healthy controls. The subjects＇ plasma E2 concentration and liver function characteristics including alanine amin- otransferase （ALT）, aspartate aminotransferase（ AST）, total bilirubin （Tbil）, direct bilirubin （Dbil）, gamma-glutamyl transpeptid- ase （GGT） and alkaline phosphatase （ALP） were performed. Covariance analysis, partial correlation and multivariate logistic regres- sion were used to discover the associations of plasma E2 level with outcomes of HCV infection and liver function. Results Controlling for the number of whole blood and/or plasma donation and liver disease （fatty liver and/or cirrhosis）, the ALT （p = o. 003 ） and AST （P = 0. 025） levels showed statistical significant differences among the 3 groups. In addition, a partial correlation analysis indicated that the level of E2 was weakly negatively correlated with ALT, AST, GGT and ALP. However, the correlation did not show statistical significance （ all P 〉 0.05 ）. The multivariate logistic regression implicated that age was independently associated with normal ALT val- ues in chronic HCV infection （ OR = 1. 122, 95% CI = 1. 036-I. 215 ）. Conclusions The administration of blood donation should be enhanced. Large, well-designed follow-up studies with ethnically-diverse populations are warranted to further elucidate the impact of E2 on HCV infection outcomes and liver function condition.

关 键 词：雌二醇 肝炎抗体 丙型 丙氨酸转氨酶 

分 类 号：R575.1[医药卫生—消化系统] R181[医药卫生—内科学]