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对52例输血前无丙型肝炎的受血者及30例无输血的对照组随访检测ALT、抗-HCV、HCVRNA等项目,进行输血后HCV感染的前瞻性研究。结果显示,52例受血者中有9例符合输血后丙型肝炎的诊断,发生率为17.3%,而对照组30例无1例感染丙型肝炎病毒(HCV),两组有统计学差异(P=0.02<0.05),且趋势检验χ2=16.67,P<0.005,提示输血传播丙型肝炎仍相当常见,本研究还观察到输血量越大感染丙型肝炎的机会越高。9例输血后丙型肝炎中的8例经1年随访,均转为慢性肝炎,反映丙型肝炎慢性化机率高。对导致9例输血后丙肝的献血员血清标本(45份)用第2代ELISA法检测抗-HCV,结果1份可疑阳性,44份阴性。用反转录PCR法检测HCVRNA,12份阳性,33份阴性。表明目前用于筛选献血员的抗-HCV方法尚不够灵敏,尚不足以筛去有可能导致HCV传播的供血,因此,避免不必要的输血以预防输血后丙型肝炎的发生仍然是应强调的原则。
Fifty-two blood transfusions without hepatitis C and 30 non-transfusion control subjects were followed up for the detection of ALT, anti-HCV, HCV RNA and other items in a prospective study of post-transfusion HCV infection. The results showed that 9 out of 52 recipients were diagnosed with hepatitis C after transfusion, with a rate of 17.3%, while none of the 30 controls were infected with hepatitis C virus (HCV) (P = 0.02 <0.05), and trend test χ2 = 16.67, P <0.005, suggesting that transfusion of hepatitis C is still quite common, the study also observed that the greater the amount of blood transfusion infection C The higher the chance of hepatitis. Eight of the nine patients with hepatitis C after transfusion were followed up for one year and were all switched to chronic hepatitis, reflecting the high rate of chronic hepatitis C infection. Serum samples from blood donors (n = 9) that resulted in hepatitis C after transfusion were screened by the second-generation ELISA for anti-HCV. One suspicious positive result and 44 negative results were obtained. HCV RNA was detected by reverse transcription PCR, with 12 positive and 33 negative. This indicates that the current anti-HCV methods used to screen blood donors are not yet sensitive enough to screen for blood that may cause HCV transmission. Therefore, it is still important to avoid unnecessary blood transfusions to prevent hepatitis C after transfusion in principle.