短期大量输血对慢性乙型肝炎患者血清标志物的影响

Influnce of Short-term Massive Blood Transfusions on Serum Markers of Hepatitis B in Patients with CHB

目的研究短期大量输血(>1 600 mL)对慢性乙型肝炎(CHB)患者血清标记物乙肝表面抗原(HBsAg)、乙肝e抗原(HBeAg)、抗-HBs、抗-HBc及抗-HBe的影响。方法选择2014年1月-2019年1月我院的204例CHB患者,840份供血者。检测840份供血者的血浆样本以及204例CHB患者短期大量输血前血清标本的HBsAg、HBeAg、抗-HBs、抗-HBc以及抗-HBe,且检测HBV-DNA;分别于204例进行短期大量输血治疗后的第1天、第2天、第4天以及第6天,检测其血清标志物。结果输血前患者的HBV-DNA、HBsAg、HBeAg以及抗-HBc明显高于供血样本(P<0.05),抗-HBs以及抗-HBe明显低于供血样本(P<0.05);输血后患者的抗-HBs,HBsAg,抗-HBc以及抗-HBe明显出现变化波动(P<0.05)。结论短期大量输血不会影响CHB患者的HBV-DNA和HBeAg,但会影响患者的抗-HBs,HBsAg,抗-HBc以及抗-HBe,对这些血清标记物的检测,有助于医生更好地了解患者病情避免误诊,能够减少或避免医院感染。

Objective To investigate the effects of short-term massive blood transfusion (>1 600 mL)on serum markers of HBsAg, HBeAg, anti-HBs, anti-HBc and anti-HBe in patients with CHB. Methods 204 patients with CHB and 840 blood donors were selected from January 2014 to January 2019 in our hospital. HBsAg, HBeAg, anti-HBs, anti-HBc and anti-HBe were detected in 840 plasma samples from donors and 204 serum samples from CHB patients before short-term massive transfusion, and HBV-DNA was also detected. Serum markers were detected in 204 patients on day 1, day 2, day 4 and day 6 after short-term massive transfusion. Results HBV-DNA, HBsAg, HBeAg and anti-HBc in patients with CHB before transfusion were significantly higher than those in blood samples (P<0.05), while anti-HBs and anti-HBe were significantly lower than those in blood samples (P<0.05). After transfusion, the anti-HBs, HBsAg, anti-HBc and anti-HBe of the patients showed significant fluctuation (P<0.05). Conclusion Short-term massive blood transfusion will not affect HBV-DNA and HBeAg of CHB patients, but will affect anti-HBs, HBsAg, anti-HBc and anti-HBe of patients. Detection of these serum markers will help doctors better understand patients’ conditions to avoid misdiagnosis and reduce or avoid hospital infection.