维持性血液透析患者丙型肝炎病毒感染的预防与预后观察

曹娅丽; 王世相; 郭苹; 刘航

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中国血液净化 ›› 2006, Vol. 5 ›› Issue (8) : 430-432.

论著

维持性血液透析患者丙型肝炎病毒感染的预防与预后观察

曹娅丽王世相郭苹刘航

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摘要

目的了解维持性血液透析（HD）患者丙型肝炎病毒（HCV）的感染情况，探讨预防控制血液透析患者HCV感染的措施。方法选择首都医科大学附属北京朝阳医院血液净化中心88例HD患者用化学发光法检测HCV抗体，随访3年，分析HCV感染与透析时间、输血、肾移植史、血清转氨酶(ALT)异常的关系，并观察转归及预后。结果 88例患者中，抗-HCV阳性率为10.2%，HCV-RNA阳性率为4.5%，HCV总感染率11.4%。随访3年无新感染者；单纯HCV感染者未出现血清转氨酶(ALT)增高及影像学所见的肝损害；5例抗-HCV(＋)伴有HBcAb(+)者均出现血清转氨酶升高及早期肝硬化表现。结论血液透析患者HCV感染率明显高于普通人群；与透析时间、输血、肾移植史有关；采取严格隔离措施，可以有效预防丙型肝炎病毒的传播；HBV与HCV同时感染者更易出现肝脏损害，值得重视。

Abstract

Objective To observe the prevalence of hepatitis C infection in maintenance hemodialysis(MHD) patients and investigate the methods to prevent and control hepatitis C infection in our dialysis unit. Methods Anti-HCV were screened Chemiluminescent Microparticle Immunoassay(CMMI) method in 88 hemodialysis patients who receive regular hemodialysis more than 3 years. HCV-RNA were detected by reverse transcription-polymerase chain reaction.The relationship between the infection of hepatitisc virus and the dialysis duration、blood infusion、renal transplantation and hepatic function were analyzed. Results Nine patients(10.2%)were in anti-HCV positive,4 patients were HCV-RNA positive. The incidence of hepatitis C in MHD patients was 11.4%.After 3 years,there were no new infection.Five patients who were infected with hepatitis B and hepatitis C had hepatic dysfunction and cirrhosis in earlier stages. Conclusion MHD patients have a higher risk of HCV infection than common people. There were significant correlation between hemodialysis duration、blood transfusion and renal transplantation.Strict isolation may effectively prevent hepatitis C infection in dialysis unit.Co-infection of Hepatitis B and hepatitis C in MHD patients should be attended strictly.