血液透析及慢性肝炎患者输血传播病毒感染的临床意义

Clinical Significance of Transfusion-transmitted Viral Infection in Patients with Chronic Hepatitis and on Hemodialysis

目的：阐明输血传播病毒（TTV）感染在血液透析、慢性肝炎病人中的临床意义及其致病作用。方法：以套式聚合酶链反应（PCR）检测血清TTVDNA。结果：31例血液透析患者10例TTVDNA阳性，其中6例有血清转氨酶（ALT）水平升高（76～243U／L），但均同时伴有HBsAg或／和抗HCV阳性，2例单纯TTVDNA阳性者血清TTVDNA持续阳性至少8个月，而ALT水平一直处在正常水平。TTVDNA阳性率在慢性乙型肝炎、慢性丙型肝炎及慢性非甲～戊型、非庚型肝炎中分别为28．3％（17／60），29．3％（10／41）和31．1％（14／45）。TTVDNA阳性、阴性两组慢性乙、丙型肝炎在年龄、病程及ALT、AST、TBil水平均无显著差异（P＞0．05）。14例非甲～戊型、非庚型肝炎患者中13例表现为单项ALT水平轻度升高，临床症状轻微。结论：TTV感染存在慢性携带状态，可能是非甲～成型、非庚型肝炎的重要致病因子，但其致病性可能较弱。

篛bjective: To investigate the clinical significance of TTV infection in patients onhemodialysis and with chronic hepatitis. Methods: A nested polymerase chain reaction (PCR) was estab-lished to detect serum TTV DNA. Results:of 31 cases on hemodialysis, 10 were TTV DNA positive. 6out of 10 TTV DNA positive patients had elevated serum alanine aminotransferase (ALT) levels (76~243U/L) and positive HBsAg and/or anti-HCV. 2 cases had persistent positive TTV DNA for at least 8months,although normal ALT levels were found. The positive rate of TTV DNA was 28.3%(17/6O) inchronic hepatitis B,29.3% (12/41) in chronic hepatitis C, and 31.1% (14/45) in chronic hepatitis non-A^E and G,respectively. No clinical and chemical significant difference was found between TTV DNApositive and negative patients with chronic hepatitis B or C between. Among 14 patients with chronicnon-A^E and positive TTV DNA, 13 had slightly elevated serum ALT and mild clinical symptoms.Conclusions:Patients infected with TTV may exist as permanent healthy carriers. TTV could be an im-portant pathogen of non-A^E and G,although its pathogenic effect might be weak.