口腔医院住院患者丙型肝炎病毒感染现状分析

Study on the status of inpatients with hepatitis C virus infection in stomatological hospital

目的:研究口腔医院感染丙型肝炎病毒(hepatitis C virus,HCV)的住院患者在性别、年龄、年份、病种上的分布及感染者的肝功能状况。方法:收集2008—2012年在南京医科大学附属口腔医院进行过丙肝抗体检测的住院病人的数据,按性别、年龄及检测年份的不同分组比较丙肝抗体的阳性率,并观察丙肝抗体阳性病人的病种情况。分析丙肝抗体阳性病人的丙氨酸氨基转移酶(alanine aminotransferase,ALT)和天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)数据,以期了解感染者的肝功能状况。结果:口腔医院住院患者抗-HCV阳性率为0.25%,低于文献中所述的一般人群3.2%的抗-HCV阳性率流行率;住院患者抗-HCV阳性病人的肝功能异常率为53.33%,较乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)阳性患者17.77%肝功能异常率有显著性提高(χ2=9.11,P<0.01)。结论:对口腔患者术前和创伤性治疗前的抗-HCV的检测能及早发现HCV感染者;同时口腔医院的医护员工需加强对病人和自身的保护,严格消毒操作器械,防止HCV的医院内传播;HCV感染者需定期进行肝功能检查,防止肝脏的损伤。

Objective：To study the distribution of inpatients that had been infected by hepatitis C virus according to their gender, age, year, disease category and the status of liver function. Methods： The data of inpatients who had taken hepatitis C antibody tests in the Affiliated Stomatological Hospital of Nanjing Medical University from 2008 to 2012 were collected. The patients with hepatitis C an- tibody positive results were grouped according to their gender, age and year, and their rates of positive results were compared. The data of ALT and AST of the patients with positive hepatitis C antibody were analysed in order to investigate the status of liver function of pa- tients with hepatitis C infection. Results： The positive rate of the inpatients （0. 25% ） in stomatological hospital was smaller than that of general population （3.2%）. The abnormal rate of liver function of the inpatients with positive anti-HCV was 53.33% , and this wa significantly higher than that （ 17.77% ） of the patients with positive HBsAG （ X~ = 9. 11 ,P 〈 0.01 ）. Conclusions： Carrying out the anti-HCV tests on dental patients before operation and traumatic treatment can find out the HCV infectors early. It is necessary to strict- ly supervise the disinfection of dental equipments. One handpiece should only be used by one patient. Clinical doctors should wear bio- logical safety protection equipments such as face masks. Dental medical staff are needed to strengthen the protection of patients and themselves, strict disinfection of equipment operation, and to prevent nosocomial transmission of HCV. Check of the liver function of the HCV patients should be carried out regularly so as to prevent their liver damage.