维持性血液透析病人HCV感染标志的检测及临床意义

Detection and Significance ofhepatitis CVirusinfectionin uremic patienton maintenance hemodialysis

为了评价血液透析病人ＨＣＶ 感染状况及对肝功能的影响，对６２ 例维持性血液透析病人应用第二代酶联免疫吸附试验和逆转录聚合酶链反应检查抗－ ＨＣＶ 和ＨＣＶＲＮＡ。结果显示：６２ 例病人中，抗－ ＨＣＶ 阳性ＩｇＭ２７ 例（４３－６ ％ ） ，抗－ ＨＣＶＩｇＧ 阳性２９ 例（４６－８ ％ ） ，ＨＣＶＲＮＡ阳性３４ 例（５４－８ ％ ） ，三项任一项阳性者３８ 例（５９－７ ％ ） ，阳性组与阴性组相比，两者在性别、年龄、肾功能、ＨＢＶ 标志、ＥＰＯ 应用、ＣＡＰＤ史无显著差异，而与平均透析时间、输血史、ＡＬＴ 异常、肾移植史有显著差异。提示血透病人中ＨＣＶ感染严重，输血为血透病人感染ＨＣＶ 的主要途径。

In orderto assessthe prevalence of HCVinfection in HDpatients and the effect on the liverfunction,62 patientsin our HDunit were evaluated by using second generation ELISAto detect serum anti HCVantibodies,RT PCRto detectserum HCVRNA,27 patients (43-6 % ) were anti HCV IgMpositive,29patients (46-8 % ) were anti HCVIgGpositive,34 patients (54-8 % ) were HCV RNA positive,thetotal positivity of HCV marker was 59-7 % (37/62)- When comparing the HCV marker positiveand negative group ,there were no significant difference in the sex ,age,renal function ,HBV markers、EPOand history of CAPD;There weresignificant differenceinthe duration of dialysis,history oftransfusion,ALTabnormality and kidneytransplantation-Theresultssuggested that HCVinfectionin HDpatients wasserious,blood transfusion appearsto bethe primaryriskfactor,butnosocomialtransmis sion of HCVin the dialyticenviroment may be present-