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目的动态追踪观察HCV感染的献血者健康状况、疾病进程和转归。方法选择刚发生HCV感染的献血者,12年中定期抽血检测,观察其HCV RNA、抗-HCV和ALT的动态变化,并按HCV RNA出现的阳性频率和转阴趋势分为两组(第1组阳性率低且趋转阴,第2组则相反),调查这些感染者的健康状况,并进行肝脾B超检查和肝组织病理检查。结果①第1组中的7名受试者血清(血浆)HCV-RNA呈间隙性阳性,阳性率为41.6%(47/113),其血清ALT异常率为14.4%(16/111),其中4名作肝活检后均诊断为轻度慢性肝炎,病理改变程度是:G1、S0和G1、S1各2例;②第2组中的19名受试者血清(血浆)HCV RNA呈持续性阳性,阳性率为88.2%(276/313),其血清ALT异常率为50.3%(159/316),其中6名肝活检也诊断为轻度慢性肝炎,但病理改变明显,G2、S2有2例,G2、S1有4例;③26名受试者一般健康状况尚佳,除部分肝脾B超呈现实质回声增强外,无其他特殊情况发现。结论26名HCV感染的献血者12年间均已发展为轻度慢性丙型肝炎;其中7名受试者病情在恢复,19名受试者病情可能有发展。
Objective To dynamically observe the health status, disease progression and outcome of blood donors with HCV infection. Methods Blood donors who had just developed HCV infection were selected and blood samples were taken regularly for 12 years to observe the dynamic changes of HCV RNA, anti-HCV and ALT. According to the positive frequency and negative trend of HCV RNA, The positive rate of 1 group was negative and turned negative, while that of group 2 was the opposite), the health condition of these infected persons was investigated, and liver and spleen B-ultrasound and liver histopathological examination were performed. Results ① The serum (plasma) HCV-RNA of 7 subjects in group 1 showed a positive seroma with a positive rate of 41.6% (47/113), and the serum ALT abnormality rate was 14.4% (16/111) Four patients with liver biopsy were diagnosed as mild chronic hepatitis, the degree of pathological changes are: G1, S0 and G1, S1 in each of 2 cases; ② second group of 19 subjects serum (plasma) HCV RNA was persistent positive , The positive rate was 88.2% (276/313). The abnormal rate of serum ALT was 50.3% (159/316). Six liver biopsies were also diagnosed as mild chronic hepatitis, but the pathological changes were obvious. There were 2 cases of G2 and S2 , There were 4 cases in G2 and S1; (3) 26 subjects had good general health status, except for some liver and spleen B ultrasound showed substantial echo enhancement, no other special circumstances were found. Conclusions 26 HCV-infected donors have developed mild chronic hepatitis C over 12 years; 7 of these subjects are recovering and 19 are likely to develop disease.