肿瘤专科医院2022年就诊患者常见传染病感染状况分析  

Infection Status of Common Infectious Diseases among Patients in Specialized Cancer Hospi tal

作　　者：张媛媛 朱浩智 许南松 余金吨 邓创忠 黄丽华 ZHANG Yuanyuan;ZHU Haozhi;XU Nansong;YU Jindun;DENG Chuangzhong;HUANG Lihua(State Key Laboratory of Oncology in South China,Guangdong Provincial Clinical Research Center for Cancer,Sun Yat sen University Cancer Center,Guangzhou 510060,China)

机构地区：[1]华南恶性肿瘤防治全国重点实验室、广东省恶性肿瘤临床医学研究中心、中山大学肿瘤防治中心,广东广州510060

出　　处：《中山大学学报（医学科学版）》2024年第4期666-672,共7页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技厅基础与应用基础研究基金(2020A1515110210)。

摘　　要：【目的】了解华南地区某肿瘤专科医院就诊患者的艾滋病病毒(HIV)、梅毒螺旋体(TP)、丙型肝炎病毒(HCV)、乙型肝炎病毒(HBV)感染现状,分析确诊检查完成情况,为加强常见传染病管理和制定医院感染防控策略提供参考。【方法】对2022年华南地区某肿瘤专科医院就诊的门诊、住院患者的传染病初筛项目HIV抗原抗体联合检测(HIV-comb)、梅毒螺旋体特异抗体(Anti-TP)、丙肝抗体(Anti-HCV)、乙肝表面抗原(HBsAg)的阳性检出率及进一步完成确诊项目检查的检测率进行统计分析。【结果】2022年就诊患者的HIV-comb阳性率为0.07%,100%患者进一步完成HIV补充确证试验,HIV总体患病率为0.06%;Anti-TP阳性率为1.99%,100%患者进一步完成梅毒螺旋体颗粒凝集试验(TPPA)及甲苯胺红不加热血清试验(TRUST)检测,梅毒总体患病率为0.51%;Anti-HCV阳性率为0.90%,仅26.61%患者进一步完成丙肝RNA定量检测,其中26.44%患者丙肝RNA高于检出下限;HBsAg阳性率为21.06%,仅54.40%患者进一步完成乙肝DNA定量检测,其中51.60%患者乙肝DNA高于检出下限。其中,门诊疑似肝炎患者核酸检测完善率低于住院(P<0.05),肝癌收治科室核酸检测完善率高于全院(P<0.05)。【结论】该肿瘤专科医院患者HIV、梅毒感染水平与一般人群相近,且100%完成确诊项目检查;丙肝、乙肝的感染处于较高水平,但核酸检测率较低,无法准确反映病毒复制水平。肿瘤专科医院应加强医务工作人员对肿瘤患者常见传染病初步筛查和确诊项目检查的重视,对传染病确诊病例提供抗肿瘤治疗的同时积极转介其到定点或综合性医院治疗,以改善其预后,提高医疗服务质量。【Objective】To understand the current status of human immunodeficiency virus(HIV),Treponema pallidum(TP),hepatitis C virus(HCV)and hepatitis B virus(HBV)infections among patients undergoing screening tests in a specialized cancer hospital in South China,and to analyze the completion of further testing for confirmation,so as to provide a reference for management of common infectious diseases and prevention of nosocomial infections.【Methods】We analyzed the positive rates of HIV antigen/antibody combination assay(HIV-comb),TP antibody(anti-TP),HCV antibody(anti-HCV)and hepatitis B surface antigen(HBsAg)among the outpatients and inpatients who underwent the screening tests in 2022.Then we examined the percentage of those patients with seropositivity for further confirmation.【Results】In patients who underwent the screening tests,the positive rate,percentage of patients for further confirmation test and overall prevalence for HIV-comb were were 0.07%,100%and 0.06%,respectively;for Anti-PT 1.99%,100%and 0.51%,respectively.Positive rate of anti-HCV was 0.90%and 26.61%of patients completed further HCV RNA quantitative assay,in 26.44%of whom,HCV RNA levels were above the detection limit.Positive rate of HBsAg was 21.06%and 54.40%of patients completed further HBV DNA quantitative assay,in 51.60%of whom,HBV DNA levels were above the detection limit.As for the nucleic acid testing among the suspected hepatitis patients,we found smaller coverage in outpatients than in inpatients and larger coverage in liver cancer patients than in other patients.【Conclusions】Compared with general population,patients in this specialized cancer hospital had similar infection levels of HIV and syphilis,and 100%of them completed further confirmation testing.Hepatitis C and hepatitis B infections were at a relatively high level,but which could not accurately reflect the level of virus replication due to insufficient coverage of nucleic acid testing.Specialized cancer hospitals should prompt medical staff to attach more importance to

关 键 词：肿瘤专科医院 患者 传染病 感染状况 筛查 诊断 

分 类 号：R197.5[医药卫生—卫生事业管理]