天津市慢性丙型肝炎患者感染途径分析  

Transmission routes of patients with chronic hepatitis C in Tianjin

作　　者：张敏[1] 韩涛[1,2,3] 肖时湘[2] 高英堂[1,2,3] 朱争艳[1,2,3] 

机构地区：[1]天津医科大学第三中心临床学院,天津300170 [2]天津市第三中心医院 [3]天津市人工细胞重点实验室,天津市肝胆疾病研究所

出　　处：《山东医药》2013年第31期1-3,共3页Shandong Medical Journal

基　　金：艾滋病和病毒性肝炎等重大传染病防治国家科技重大专项项目(2012ZX10002004-011)

摘　　要：目的分析天津市133例慢性丙型肝炎（丙肝）患者的感染途径，为丙肝的预防提供依据。方法2009～2012年天津市133例确诊为慢性丙型肝炎患者，通过患者的主诉确定丙肝的感染途径。采用FQ．PCR技术检测血清HCVRNA定量，对于HCVRNA定量〉1000IU／mL者参照文献采用基因芯片行HCVRNA基因型检测。应用全自动生化分析仪检测肝功能。结果133例慢性丙肝患者感染途径有输血及血制品76例，手术10例，牙齿治疗13例，穿耳洞、纹身13例，母婴传播1例，吸毒5例，不明原因15例。38例患者进行病毒基因型检测，1b型患者32例，2a型患者5例，3型患者1例。其中1b型患者输血或血制品感染18例，2a型患者输血或血制品感染4例。2000年之前经输血或血制品感染丙肝的感染率（84．1％）显著高于2000年及之后感染者（23．1％），P〈0．01（r=30．70），而2000年及之后感染者多数是经纹身、穿耳洞、吸毒等不良生活方式感染。输血及血制品感染者与非输血感染者的年龄分别为（53．84±10．94）、（42．70±12．71）岁，白蛋白（ALB）水平分别为（37．08±6．68）、（41．10±5．18）g／L，两者比较，P均〈0．01；病毒载量、丙氨酸氨基转氨酶（ALT）、总胆红素（TBIL）、甲胎蛋白（AFP）三指标在两者之间无统计学差异。不同年龄段慢性丙肝患者血清学指标比较，P均〉0．05。结论HCV感染者的感染途径包括经输血及血制品途径及经纹身、牙齿治疗、吸毒等非输血途径，病毒基因型多数为1b和2a型，对目前丙肝的主要感染途径进行有效阻断是防止丙肝感染的重要途径。Objective To analyse the transmission routes of 133 patients with chronic hepatitis C in Tianjin and to provide basis for prevention of hepatitis C. Methods A total of 133 patients with chronic hepatitis C in Tianjin from 2009 to 2012 were retrospectively analyzed. The hepatitis C virus （HCV） infection routes were confirmed by the patients＇ complaint. The serum HCV RNA was detected by FQ-PCR. For the patients whose HCV RNA 〉 1 000 IU/mL, their HCV gen- otypes were tested by gene chip according to previous report. The liver function was detected by automatic biochemistry analyzer. Results Among the 133 chronic hepatitis C patients, 76 patients had history of blood or blood products transfusion, 10 patients had history of surgery, 13 patients had history of dental treatment, 13 patients had history of ear piercing or tat-tooing, 5 patients had history of drug taking, one patient was infected by mother-to-fetus transmission and 15 patients were infected by unidentified ways. HCV genotype was tested in 38 patients, among them, 32 patients were genotype lb, 5 patients were genotype 2a, one patient was genotype 3. Eighteen patients with genotype lb and 4 patients with genotype 2a had history of blood or blood products transfusion. The infection rate through blood or blood products transfusion was higher in patients infected before the year of 2000 （84.1%） than that of patients in and after 2000 （23.1% ）, P 〈 0.01 （χ±2 = 30.70）. Most patients infected in and after 2000 had history of unhealthy life styles such as tattooing, ear piercing, drug taking etc. The patients infected by blood or blood products was older[ （53.84 ± 10.94） vs. （42.70 ± 12.71 ） （P 〈 0.01 ） ] and had a lower albumin（ALB） levels [ （37.08 ± 6.68） g/L vs. （41.10 ± 5.18） g/L （P 〈 0.01 ） ] than those infected by other routes, whereas no significant differences were found between viral load, alanine aminotransferase （ALT）,total bilirubin （TBIL）, alpha fetoprotein （AFP）. The above sero

关 键 词：病毒性肝炎 丙型肝炎病毒 病毒感染途径 输血传播病毒 母婴传播 

分 类 号：R512.63[医药卫生—内科学]