HCV合并HIV和HBV患者的实验室指标变化特征分析  

Analysis on the change characteristics of laboratory indexes in HCV patients co-infected with HIV and/or HBV

作　　者：冯程 陈友惠 李黎 王辉 李生浩 杨永锐 FENG Cheng;CHEN Youhui;LI li;WANG Hui;LI Shenghao;YANG Yongrui(The Department of Hepatopathy and Gastroenterology,Third People's Hospital of Kunming/Yunnan Provincial Clinical Medical Center,Kunming Yunnan 650041,China)

机构地区：[1]昆明市第三人民医院/云南省传染性疾病临床医学中心肝病消化科,云南昆明650041

出　　处：《云南医药》2024年第6期13-17,共5页Medicine and Pharmacy of Yunnan

摘　　要：目的分析HCV合并HIV和或HBV感染引起机体实验室指标的变化特征。方法以昆明市第三人民医院2013年10月-2019年10月收治的3492例丙肝患者作为研究对象,分为HBV/HCV组、HIV/HCV组、HIV/HCV/HBV组、单一HCV组,分析四组抗病毒治疗前的实验室检测指标。结果四组在性别、年龄上差异有统计学意义(P<0.05),HIV/HCV组、HIV/HCV/HBV组感染年龄小于HCV/HBV组、单一HCV组,差异有统计学意义(P<0.05),四组均以男性比例较高。HIV/HCV组基因2型所占比例较HCV/HBV组、单一HCV组低,HIV/HCV组基因3型所占比例较单一HCV组高。HIV/HCV组较单一HCV组WBC、NE、Hh、PLT明显降低,HIV/HCV组、HIV/HCV/HBV组较单一HCV组和HBV/HCV组LYM、RBC降低。HCV/HBV组较单一HCV组PTA显著降低,INR明显延长,HIV/HCV组TT较单一HCV组延长,HCV/HBV组、HIV/HBV组较单一HCV组TBIL、DBIL、IBIL、ALT、TBA升高,ALB、PA明显降低。结论云南地区HCV感染者以男性多见,基因型多样化,HCV合并感染更易出现血常规异常、肝功能受损和凝血功能障碍。Objective To analyze the changes of laboratory indicators in the body caused by HCV combined with HIV and/or HBV infection.Methods A total of 3492 patients with hepatitis C treated in Kunming Third People's Hospital from Oct.2013 to Oct.2019 were selected as the research objects.They were divided into HBV/HCV co-infection group,HIV/HCV co-infection group,HIV/HCV/HBV co-infection group and single HCV infection group.The laboratory test indexes of four groups of infected patients before antiviral treatment were retrospectively analyzed.Results There were differences in gender and age in the four groups(P<0.01).The infection age of HIV/HCV group and HIV/HCV/HBV group was lower than that of HCV/HBV group and single HCV group,and the difference was statistically significant(P<0.01),and the proportion of male patients was higher in all four groups.The proportion of genotype 2 in HIV/HCV group was lower than that in HCV/HBV group and single HCV group,while the proportion of genotype 3 in HIV/HCV group was higher than that in single HCV group.The WBC,NE,Hh and PLT of HIV/HCV group were significantly lower than those of single HCV group,while LYM and RBC of HIV/HCV group and HIV/HCV/HBV group were significantly lower than those of single HCV group and HBV/HCV group.Compared with the single HCV group,the PTA was significantly decreased and INR was significantly prolonged in the HCV/HBV group,and TT was significantly prolonged in the HIV/HCV group compared with the single HCV group.TBIL,DBIL,IBIL,ALT and TBA in HCV/HBV group and HIV/HBV group were significantly higher than those in single HCV group,while ALB and PA were significantly lower.Conclusions Male patients with HCV infection are more common in Yunnan area,with diverse genotypes.Patients with HCV co-infection are more likely to have abnormal blood routine,impaired liver function and coagulopathy.

关 键 词：乙型肝炎病毒 丙型肝炎病毒 人体免疫缺陷病毒 重叠感染 实验室指标 

分 类 号：R512.91[医药卫生—内科学] R512.63[医药卫生—临床医学] R512.62