维持性血液透析患者感染乙型和丙型肝炎的分析

Analysis of hepatitis B virus and hepatitis C virus infection in patients with maintenance hemodialysis

目的为了评价血液透析（血透）患者乙型和丙型肝炎（HBV、HCV）感染状态及对临床情况和肝功能的影响。方法对62例血透患者应用ELISA法和RT-PCR法检测抗-HCV和HCVRNA，采用斑点杂交法和固相放免法检测HBV标志，并检测肝功能和血浆蛋白电泳。结果62例患者中，抗-HCVIgM阳性27例（43．6％），抗-HCVIgG阳性29例（46．8％），HCVRNA阳性34例（54．8％），三项任一项阳性37例（59．7％），5例（8．1％）HBsAg阳性，其中HBeAg和HBVDNA阳性3例。结论向透患者中HCV感染严重，临床情况及预后差，检测血浆蛋白和电泳较肝功能酶学能更好地作为肝炎诊断和反映病情的指标。

Objective in order to assess the prevalence of hepatitis B virus(HBV) and hepatitis C virus(HCV) infection in hemodialysis (HD)patients and the effect on the clinical states and liver function. Methods 62 HD patients were evaluated by using ELISA to detect serum anti-HCV antibodies, RT-PCR to detect HCV RNA, dot blot to detect HBV DNA and RIA to detect HBV markers. All patients were examined for liver function test and serum protein electrophoretic Patterns.Results 27 patiens (43.6%)were anti-HCV IgM positive, 29 patients(46.8%) were anti-HCV IgG positive, 34patients (54.8%)were HCV RNA positive,the total positivity of HCV marker was 59.7% (37/62), 5 patients were HBsAg positive,among them, 3 patients were both HBeAg and HBV DNA positive. Conclusion HCV infection in HD patients is serious, which leads to a bad clinical manifestation and prognosis. Detection of serum protein and electrophoretic patterns are more valuable markers in the diagnosis of HCV infection in hemodialysis patients and also the presence of correlation with the clinic states of hepatitis C shown.