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目的对2011年下半年涡阳县丹城镇所爆发的丙肝疫情区的人群各项丙肝指标检测结果进行分析,观察其对局部性的丙肝疫情爆发的检测所能给出的指导意义。方法对来自疫情区的人群(共9389人)分别检查谷丙转氨酶(ALT)和抗-HCV(ELISA法)。ALT测值异常(>40U/L)人群或抗-HCV检测为阳性的人群,再采用实时荧光定量聚合酶链反映(FQ-PCR)技术对丙型肝炎病毒核酸(HCV-RNA)进行定量检测。结果 ALT测值异常(>40U/L)一共有405人,抗-HCV阳性为330人,共计562人。在这些异常的人群中采用实时荧光定量技术检测HCV-RNA,结果 >1000 copies/ml(阳性)共计139人。本院在疫情区的后期随访过程中,经PCR法检测HCV-RNA,新增确诊患者55例。结论局部性爆发丙肝疫情时,应遵守及早发现,及早介入治疗的原则。结合当前临床常用检查方法 ,建议疫情区基层医院早期筛查项目是检测ALT、HCV-cAg和抗-HCV(ELISA法),然后针对初筛结果异常人群再运用实时荧光定量PCR技术检测血清HCV-RNA进行确诊。ALT、HCV-cAg和抗-HCV结果正常的高危人群,建议每年应进行一至两次HCV健康筛查。
Objective To analyze the results of various hepatitis C tests in the areas of hepatitis C outbreak in Dancheng Town of Guoyang County in the second half of 2011 and to find out its guiding significance for the detection of the local outbreak of hepatitis C outbreak. Methods Alanine aminotransferase (ALT) and anti-HCV (ELISA) were examined in the population from a total of 9389 people in the outbreak area. Patients with abnormal ALT test (> 40U / L) or anti-HCV test were screened for HCV-RNA using real-time fluorescence quantitative polymerase chain reaction (FQ-PCR) . Results There were 405 ALT abnormalities (> 40U / L) and 330 anti-HCV positives (562). HCV-RNA was detected by real-time fluorescence quantification in these abnormal populations, with a total of 139 people> 1000 copies / ml (positive). In our hospital during the follow-up period of epidemic situation, HCV-RNA was detected by PCR method, and newly diagnosed patients were 55 cases. Conclusions Local outbreak of hepatitis C should follow the principle of early detection and early intervention. Combined with the current clinical examination methods, it is recommended that the primary screening project of grass-roots hospitals in the outbreak area is to detect ALT, HCV-cAg and anti-HCV (ELISA), and then detect the serum HCV- RNA is diagnosed. High-risk populations with normal ALT, HCV-cAg, and anti-HCV outcomes recommend one or two HCV health screening annually.