广东省惠州地区尿毒症患者乙型肝炎病毒和丙型肝炎病毒感染特征分析

Analysis of hepatitis B and C virus infection in uremic patients in huizhou

目的:探讨广东省惠州地区尿毒症患者乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)的感染特征,了解其隐匿性肝炎发生情况。方法:选取惠州市第一人民医院收治的尿毒症患者123例作为尿毒症组,选取同期体检的75例人员作为对照组,检测患者的HBsAg和HBV滴度、血清HCV核酸滴度、PBMCs HCV核酸滴度及谷草转氨酶(AST)、谷丙转氨酶(ALT)、白蛋白(ALB)、总蛋白(TP)水平。结果:尿毒症患者HBV感染率为13.01%,HCV感染率为4.88%,与体检人员比较差异无统计学意义(P=0.836和0.085)。尿毒症患者的AST、ALT、ALB、GLB、TP水平均显著低于体检人员(P=0.000-0.001)。HBV感染组的血清病毒核酸滴度1.47×10^(2) IU/ml-1.02×10^(7) IU/ml,HCV感染组的血清病毒核酸滴度3.47×10^(5) IU/ml-9.92×10^(6) IU/ml,PBMCs中HCV核酸滴度2.08×10^(3) IU/ml-1.25×10^(6) IU/ml。HBV感染组和HCV感染组均以男性患者为主,分别占87.5%和66.67%,显著高于非肝炎组间(P=0.005),三组间AST、ALT水平比较差异有统计学意义(P=0.000)。尿毒症患者中发现2例隐匿性乙肝感染患者和1例隐匿性丙肝感染患者,感染率分别为1.63%和0.81%。结论:尿毒症患者HBV和HCV感染率仍较高,且有隐匿性感染病例。重视肝炎病毒核酸检测,对防治尿毒症患者肝炎传播具有重要的临床价值。

Objective To investigate the infection characteristics of hepatitis B virus(HBV)and hepatitis C virus(HCV)in patients with uremia in Huizhou,Guangdong,and to understand the incidence of occult hepatitis.Method 123 patients with Uremia were selected as the Uremia group,and 75 patients with physical examination at the same time were selected as the control group,to detect the HBsAg and HBV titers,serum HCV nucleic acid titers,PBMCs HCV nucleic acid titers,and the levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT),albumin(ALB),and total protein(TP).Results The HBV infection rate and HCV infection rate in uremic patients were 13.01%and 4.88%respectively,with no significant difference compared with those in physical examination(P=0.836 and 0.085).The levels of AST,ALT,ALB,GLB and TP in uremic patients were significantly lower than those in physical examination patients(P=0.000-0.001).The serum nucleic acid titer of HBV infection group was 1.47×10^(2) IU/ml-1.02×10^(7) IU/ml,serum viral nucleic acid titer of HCV infection group 3.47×10^(5) IU/ml-9.92×10^(6) IU/ml,HCV nucleic acid titer in PBMCs 2.08×10^(3) IU/ml-1.25×10^(6) IU/ml.The HBV infection group and HCV infection group were dominated by male patients,accounting for 87.5%and 66.67%respectively,which were significantly higher than those in the non hepatitis group(P=0.005).The AST and ALT levels among the three groups were statistically different(P=0.000).Two patients with latent hepatitis B infection and one patient with latent hepatitis C infection were found in uremic patients,and the infection rates were 1.63%and 0.81%respectively.Conclusion HBV and HCV infection is still high in uremic patients,and there are occult infection cases.It is of great clinical value to pay attention to the detection of hepatitis virus nucleic acid for the prevention and treatment of the spread of hepatitis disease in uremic patients.