乙型肝炎e抗原阴性表面抗原阳性携带者手术期的感染及预防

The Infectious Risk and Precautionary Measures of HBsAg Carriers of HBeAg Negativity during Operation

目的 探讨乙型肝炎 e抗原 (HBe Ag)阴性表面抗原 (HBs Ag)携带者 ,经手术传播的危险性及预防方法。 方法 根据套式 PCR定量检测 HBV DNA确定的 HBV传染性和传播阈值 ,参考疫苗接种对 HBV易感性的影响 ,将 HBV携带者分为低度、高度和极高传染性 3个等级 ,评价 HBe Ag与 HBV经手术传播的关系。结果 监控组、非监控组和肝炎组高度传染性 HBV携带者例数与各自总例数之比分别为 1/1.19、1/2 5 0和 1/4.4 4 ;极高传染性者分别为 1/5 .16、0和 0 ;HBe Ag阴性肝炎患者的 HBV感染模式与 HBe Ag阴性外科患者相同 ,但 HBV携带率和传染性都显著大于后者 ;HBs Ag和抗 HCV阳性无关。结论 手术中对 HBe Ag阳性患者必须采取加强预防措施 ;对 HBe Ag阴性外科患者则无此必要 ;对 HBe Ag阴性肝炎患者采取的预防措施应该与 HBe Ag阳性患者相同。

OBJECTIVE To investigate the infectious risk and precautionary measures of HBsAg carriers of HBeAg negativity during operation.METHODS In accordance with the HBV infectivity and the spread threshold value determined by PCR quantitative HBV DNA, and consult of the effect of vaccination on host′s HBV susceptibility, HBV carriers were divided into three grades, these are low, high and the highest infectivity. To evaluate the relationship between HBeAg and HBV spread during operation.RESULTS The ratio of the number of the high infectious HBV carriers in the supervising control, non supervising control and hepatitis groups with each total number is 1/1.19, 1/25 and 1/4.44, respectivey. The ratio of the highest infectious HBV carriers is 1/5.16, 0 and 0, respectively. The HBV infectous model of HBeAg negative hepatitis patients is identical as HBeAg negative surgical patients, but both the HBV rate and the infectivity of the former are larger than the latter. HBsAg has no relation with anti HCV positive.CONCLUSIONS [HT5”,6SS]The strengthened precautionary measures must be taken in HBeAg positive patients during operation, but it is not necessary in HBeAg negative surgical patients. The precautionary measures taken in HBeAg negative hepatitis should be as same as in HBeAg positive patients.