血液透析患者感染丙型病毒性肝炎因素的Logistic回归分析

Logistic Analysis of Risk Factors of Hepatitis C Virus in Patients with Maintenance Hemodialysis

目的 分析影响维持性血液透析患者感染丙型肝炎的危险因素。方法 收集 12 0例血透患者的临床资料 ,采用第二代 EL ISA法检测血抗 - HCV;临床资料包括 :年龄、性别、血透时间、每周透析时间、输血和血制品史和量、合并 HBV感染、肾脏移植史、CAPD史、AL T异常史、肝炎史、结核史以及医院感染史等。结果 单因素分析表明 HCV感染与透析时间、每周透析时间、输血、血制品史和量、肾移植史、医院感染史、AL T增高史显著性相关 ;L ogistic逐步回归分析证实 HCV感染的原因为输血和医源性传播。结论 结果提示要采取严格的预防措施 ,减少输血和隔离抗 - HCV阳性患者 ,对控制 HCV感染意义重大。

OBJECTIVE To analyze the risk factors of hepatitis C virus(HCV) infection in hemodialysis(HD) patients.METHODS The data of 120 patients in our hemodialysis unit were collected to detemine the prevalence, risk factors and the clinical consequences of infection by HCV. Serum samples were tested for anti HCV antibodies using second generation ELISA. Collected data included age, gender, duration on HD, weekly dialysis time, history and number of blood and blood product transfusion, co infection with HBV, history of kidney transplantation, CAPD and, ALT abnormality, hepatitis,tuberculosis and infection at hospital.RESULTS Single factor analysis showed that HCV infection was associated with duration on HD, weekly dialysis time, history and number of blood transfusion, kidney transplantation and infection at hospital.Logistic regression analysis showed that the contamination was both transfusional and nosocomial. CONCLUSIONS The results underscore the need for a strict compliance with 'universal precaution' in dialysis unit and suggested that isolation of anti HCV positive patients during dialysis and limitation of blood transfusion decrease the transmission of HCV in HD patients.