162例丙型肝炎患者远期转归研究

Longterm Outcomes of 162 Cases Involving Hepatitis C

目的观察162例不同临床感染类型丙型肝炎(HC)患者16年后的转归情况。方法将162例HC患者按急性期症状分组,采集5ml静脉血,检测丙型肝炎病毒(HCV)抗体、RNA、丙氨酸氨基转移酶(ALT)、透明质酸(HA)、Ⅲ型前胶原肽(PCⅢ)和Ⅳ型胶原(ⅣC)。结果本次调查的162例患者中抗-HCV阳性率为95.7%,HCVRNA阳性率为77.8%,ALT异常率为20.4%,不同临床类型HC患者抗-HCV、HCVRNA阳性率和ALT异常率间差异无统计学意义(P>0.05)。HA异常率为64.2%,PCⅢ异常率为9.3%,ⅣC异常率为40.1%。HA、PCⅢ和ⅣC3项指标均正常者共28例(18.52%),11例(6.8%)3项指标均处于肝硬化临界值。经性别分层分析,女性感染年龄≥40岁者抗体较易阴转(P=0.004)。结论不同临床型HC患者16年后的转归无差异,个体转归差异与性别和初始感染年龄有关。

Objective To observe the long outcomes of 162 cases involving hepatitis C with different infection type for 16 years. Methods 162 cases were divided into different groups according to their symptoms at acute stage. Five milliliter of blood were taken from each patient and the serum level of ALT, HCV - RNA, Anti - HCV, hyaluronic acid （HA）, Ⅲ precollagen （PCIU）, Ⅳ collagen （IVC） were tested. Results 95.7% of 162 cases showed positive anti - HCV, 77.8% of them showed positive HCV - RNA. The abnormal rate of ALT was 20. 4%. The rates of positive anti - HCV, positive HCV - RNA and the abnormal ALT were no significant differences among the different kinds of hepatitis C （ P 〉 0. 05）. The abnormal rates of HA, PCIU and IVC were 64. 2% , 9. 3% and 40. 1% respectively. 28 （ 18.5% ） out of 162 cases presented normal value on the three indexes and 11 （6. 8% ） cases were abnormal. Stratified analysis showed that anti - HCV in serum was easier to be changed to negative in female of infection age over 40 years old than other patients （ P = 0. 004）. Conclusion There was no significant differences in the 16 - year outcomes among different kinds of hepatitis C. The individual outcome was related to the sex and the initial infection age.