维持性血液透析患者丙型肝炎病毒感染的血清学变化及危险因素分析:附三年随访资料

Serological variation and risk factors of HCV in maintenance hemodialysis patients with 3-year of follow-up

目的探讨维持性血液透析(MHD)患者丙型肝炎病毒(HCV)感染的血清学变化及其危险因素。方法以2009年2月在我院进行MHD的184例患者为研究对象。随访3年。收集患者临床和实验室资料。分析MHD患者HCV感染的患病情况、血清学变化及其危险因素。结果 (1)184例MHD患者中HCV抗体和(或)HCV-RNA阳性者20例,阳性率为10.8%,其中HCV抗体合并HCV-RNA阳性者11例,占55%。(2)在年龄和性别方面,丙型肝炎阳性患者与丙型肝炎阴性患者相比,差异无统计学意义;而在透析龄、输血史和肾移植史方面,两组相比差异具有统计学意义(P均<0.05)。进一步行二项式回归分析,结果显示,输血史及肾移植史是透析患者并发HCV感染的独立危险因素。(3)随访3年,无1例新发HCV感染。20例合并HCV抗体和(或)HCV-RNA阳性的透析患者有4例转阴,其阴转率为20%。结论血液透析患者HCV感染患病率下降可能与其HCV血清学阴转有关。输血史和肾移植史是透析患者并发HCV感染的独立危险因素。

Objective To investigate the serological variation and its risk factors of HCV infection in maintenance hemodialysis（MHD）patients. Methods A total of 184 MHD patients on Feb. 2009 were enrolled in this study. The total follow-up time was 3 years. The following data were collected ： age, gender, dialysis duration, blood transfusion and kidney transplantation, t test, X2 test and binary logistic regression analysis were performed for statistics. Results Among the 184 MHD patients,20 patients were HCV antibody positive. The prevalence of HCV infection in MHD patients were 10. 8%. Among of the 20 HCV-positive MHD patients,11 patients（55% ）were HCV antibody and HCV-RNA positive. There were no significant differences in age and gender between HCV-positive and HCV-negative MHD patients. There were significant differences in dialysis duration, blood transfusion and kidney transplantation between HCV-positive and HCV-negative MHD patients. Binary logistic regressive analysis revealed that blood transfusion and kidney transplantation were the independent risk factors of HCV infection in MHD patients. No new HCV infection in 3 years. 4（20% ） of the HCV-positive MHD were seronegative in 3-year follow-up. Conclusions The prevalence of HCV infection in MHD patients decreased was due to HCV being seronegative. Blood transfusion and kidney transplantation were the independent risk factors of HCV infection in MHD patients.