血液病儿童输注血制品后病毒感染风险的前瞻性调查

Prospective study on transfusion-related infection in children with hematological disorders

目的 了解血液病儿童输注血制品后的感染情况。方法 用ELISA法检测输血制品前后甲～庚肝的抗原或抗体。结果 63例每人平均接受8.8人次和1250ml的血制品,输前CMV IgG(+)88％,Anti-HBs(+)50％,EBVIgG(+)16％,HEVIgG(+)4.7％,Anti-HBc(+)4.7％,Anti-HBe(+)3.2％,输后总的感染率各自为91.2％,50％,20.7％,4.7％,4.7％,3.2％,前后无统计学差异。输后新出现阳性结果7例,2例CMV IgG,1例HCV IgG,3例EBVIgG,1例HBs-Ag,没有新发现HEV、HGV、CMV IgM、EBV IgM及HBV-Ag阳性。新感染病例与输注量及人次无相关性。结论 提示上海地区血制品相对安全。

Objective To study the incidence of transfusion -related infection in children with hematological disorders. Medt-hods ELISA methods were used to detect dynamic changes of Anti-HAV-IgM, HBs-Ag, Anti-HBs, HBeAg, Anti-HBe, Anti-HBc, Anti-HBc-IgM, Anti-HCV-IgG, Anti-HEV-IgG, IgM, HGV-PCR, EBVIgG.IgM, CMV IgG,IgM before and after blood products transfusion in children with hematological disorders. Results Sixty-three children received average 8.8 times of 1250 ml blood products raspectively. Of them, 88% showed CMV IgG positive, 50 % Anti-HBs positive, 16% EBV IgG positive, 4.7% HEV IgG positive, 4.7 % Anti-HBc positive, and 3. 2% Anti-HBe positive before transfusion, but after transfusion the positive rate was 91.2%, 50%, 20.7% , 4.7% , 4.7%, 3.2% respectively. There were no differences between before and after transfusion. We found 7 newly positive cases after transfusion including 2 cases CMV IgG, 1 cases HCV IgG, 1 cases HBsAg and 3 cases EBV, but no new cases was found with HEV, HGV, CMV IgM, EBV IgM and HBV antigen. Those newly identified cases were not associated with average times and amount of transfusion. Conclusion Blood products in Shanghai are comparatively safer for those who receive blood products repeatedly.