云南省德宏州人民医院缅甸籍华裔慢性丙型肝炎流行病学特点分析

Epidemiological features of Chinese Burmese patients with chronic hepatitis C in the People's Hospital of Dehong Prefecture, Yunnan Province, China

目的：分析云南省德宏州慢性丙型肝炎（chronic hepatitis C, CHC）患者的临床资料，了解云南省缅甸籍华裔中CHC的流行病学特征和临床特点。方法回顾性分析172例于2009年1月-2012年12月就诊于我院感染科的缅甸籍华裔和中国籍CHC患者的流行病学特点。结果①172例中男88例，女84例，年龄14～73（44.47±11.34）岁，绝大多数为缅甸籍华裔（107/172，62.21%），其中以女性（63例）和＞40岁（80例）居多，年龄大于中国籍患者（P均〈0.05），职业以商人（68例）为主，感染途径以注射、输血和手术等医源性感染为主。②缅甸籍华裔患者大多无临床症状，主要通过体检发现；绝大多数患者病程＜10年；合并HIV感染率明显低于中国籍患者（7.48% vs.35.38%，P〈0.001）。③缅甸籍华裔和中国籍患者基线HCV RNA水平、肝硬化发病率及病程等之间差异无统计学意义（P均〉0.05）。④26例行HCV基因型检测的患者中17例为缅甸籍华裔，检测结果为3b型5例，6型4例，1b型2例，2a型1例，3a型1例，不能分出型4例。结论①缅甸籍华裔CHC患者以女性、40岁以上、商人为主，感染途径主要为医源性感染，基线HCV RNA水平、肝硬化发病率及病程与中国籍患者之间差异无统计学意义。②缅甸籍华裔患者HCV基因型呈多样化，以基因3b、6型及不能分型为主，合并HIV感染率明显低于中国籍患者。

Objective To analyze the epidemiological and clinical data of patients with chronic hepatitis C （CHC） in Dehong Prefecture, Yunnan Province, so as to investigate the epidemiological and clinical features of CHC in Chinese Burmese patients in Dehong Prefecture. Methods The epidemiological features of 172 Chinese Burmese and Chinese CHC patients treated in infectious diseases department of our hospital from Jan. 2009 to Dec. 2012 were analyzed retrospectively. Results Of 172 CHC patients, 88 were males and 84 were females. The age ranged from 14 to 73 years with a mean age of 44.47 ±11.34 years. Of all the patients, 107 were Chinese Burmese, accounting for the largest proportion （62.21%）. Of Chinese Burmese patients, 63 were females, and 80 were more than 40 years old. The Chinese Burmese patients were older than the Chinese patients （P〈0.05）. Sixty-eight Chinese Burmese patients were merchants. The Chinese Burmese patients were mainly infected with HCV through the routes of transmission of nosocomial infection such as injections, blood transfusion and surgery. The Chinese Burmese patients were asymptomatic, and were found to be infected with HCV by making physical examination. The courses of the disease was less than 10 years. The number of the Chinese Burmese CHC patients with HIV infection was less than that of the Chinese CHC patients with HIV infection （7.48%vs. 35.38%, P〈0.001）. No significant differences in the baseline level of HCV RNA, the occurrence rate of liver cirrhosis and the course of the disease were found between the Chinese Burmese patients and the Chinese patients （P〈0.05）. Of 26 patients whose genotypes were detected, 17 were Chinese Burmese, 5 with genotype 3b, 4 with genotype 6, 2 with genotype 1b, 1 with genotype 2a, 1 with genotype 3a and 4 unable to be identified. Conclusions The Chinese Burmese CHC patients are characterized by the large proportion of females, the age older than 40 years and merchants, being infected through the routes of transmission of nosocomial infection, and no significant differences in the baseline level of HCV RNA, the occurrence rate of liver cirrhosis and the course of the disease from the Chinese patients. The genotypes of HCV in the Chinese Burmese CHC patients are diverse and are mainly genotype 3, 6 and the ones that identified. The number of the Chinese Burmese patients with HCV/HIV co-infection is less than that of the Chinese patients.