Objective: To explore cytomegalovirus （CMV） infec-tion in recipients of liver transplantation （LT）.Methods: 30 recipients of LT were screened for theappearance of CMV infection by using ELISA to testanti-CMV-Ab fr...Objective: To explore cytomegalovirus （CMV） infec-tion in recipients of liver transplantation （LT）.Methods: 30 recipients of LT were screened for theappearance of CMV infection by using ELISA to testanti-CMV-Ab from serum samples and using im-munohistochemistry method to test CMV antigen ex-pression and nested-PCR to amplify CMV-DNA fromblood samples.Results: Four of 243 samples taken from 30 recipientscame out positive of anti-CMV IgC; and anti-CMVIgM with a positive rate of 100% and 1.6% respec-tively. 85 samples resulted in CMV antigen expression（35.0%） with the average antigen index being 4.2±3.1/5×10;WBC. Besides, 99 samples were found tobe positive by nested-PCR with a positive rate of40.7%. 61 samples were found to be simultaneously pos-itive in test of CMV antigen and DNA, with a rate of25.1%.Conclusions: Infection of CMV is common in recipi-ents of LT. Simultaneous screening of anti-CMV-Ab, CMV-Ag and CMV-DNA after liver transplanta-tion is very important for early diagnosis of CMV in-fection.展开更多
目的评价肿瘤相关抗原自身抗体(TAAb)在慢性乙型肝炎相关肝硬化(CHB肝硬化)人群中筛查肝癌的成本效果。方法构建40岁CHB肝硬化患者模拟队列,样本量为10000例。以单独TAAb筛查或TAAb与甲胎蛋白(AFP)并联筛查(TAAb+AFP)为研究策略,以肝脏...目的评价肿瘤相关抗原自身抗体(TAAb)在慢性乙型肝炎相关肝硬化(CHB肝硬化)人群中筛查肝癌的成本效果。方法构建40岁CHB肝硬化患者模拟队列,样本量为10000例。以单独TAAb筛查或TAAb与甲胎蛋白(AFP)并联筛查(TAAb+AFP)为研究策略,以肝脏超声与AFP并联筛查(肝脏超声+AFP)为对照策略,构建决策分析马尔科夫模型并对模型效度进行评价。以6个月为周期,通过TreeAge Pro 2020软件实现模拟运转,计算成本和质量调整生命年(QALY),采用增量成本效果比(ICER)进行策略间的比较,通过敏感性分析评价结果的不确定性。结果建立的马尔科夫模型共有11个转归状态,其中7个为自然转归,4个为临床干预转归,拟合优度为0.969。采用TAAb+AFP策略进行肝癌筛查的终生筛查成本为249612元/例,人均获得的QALY为7.704年,与肝脏超声检查+AFP策略(247805元/例)相比,总卫生费用增加1807元/例,多获得的QALY为0.014,ICER为127635元/QALY。当TAAb筛查费高于889.552元,或贴现率高于0.068,或抗病毒治疗依从性低于45.1%时,ICER>212676元/QALY。单次TAAb筛查费为400~600元时,TAAb+AFP策略具有成本效果价值。当支付意愿为70892、141784和212676元/QALY时,TAAb+AFP策略具有成本效果的概率分别为70.6%、75.3%和77.8%。结论对中国CHB肝硬化人群采用TAAb+AFP策略进行肝癌早期筛查具有成本效果价值。展开更多
文摘Objective: To explore cytomegalovirus （CMV） infec-tion in recipients of liver transplantation （LT）.Methods: 30 recipients of LT were screened for theappearance of CMV infection by using ELISA to testanti-CMV-Ab from serum samples and using im-munohistochemistry method to test CMV antigen ex-pression and nested-PCR to amplify CMV-DNA fromblood samples.Results: Four of 243 samples taken from 30 recipientscame out positive of anti-CMV IgC; and anti-CMVIgM with a positive rate of 100% and 1.6% respec-tively. 85 samples resulted in CMV antigen expression（35.0%） with the average antigen index being 4.2±3.1/5×10;WBC. Besides, 99 samples were found tobe positive by nested-PCR with a positive rate of40.7%. 61 samples were found to be simultaneously pos-itive in test of CMV antigen and DNA, with a rate of25.1%.Conclusions: Infection of CMV is common in recipi-ents of LT. Simultaneous screening of anti-CMV-Ab, CMV-Ag and CMV-DNA after liver transplanta-tion is very important for early diagnosis of CMV in-fection.
文摘目的评价肿瘤相关抗原自身抗体(TAAb)在慢性乙型肝炎相关肝硬化(CHB肝硬化)人群中筛查肝癌的成本效果。方法构建40岁CHB肝硬化患者模拟队列,样本量为10000例。以单独TAAb筛查或TAAb与甲胎蛋白(AFP)并联筛查(TAAb+AFP)为研究策略,以肝脏超声与AFP并联筛查(肝脏超声+AFP)为对照策略,构建决策分析马尔科夫模型并对模型效度进行评价。以6个月为周期,通过TreeAge Pro 2020软件实现模拟运转,计算成本和质量调整生命年(QALY),采用增量成本效果比(ICER)进行策略间的比较,通过敏感性分析评价结果的不确定性。结果建立的马尔科夫模型共有11个转归状态,其中7个为自然转归,4个为临床干预转归,拟合优度为0.969。采用TAAb+AFP策略进行肝癌筛查的终生筛查成本为249612元/例,人均获得的QALY为7.704年,与肝脏超声检查+AFP策略(247805元/例)相比,总卫生费用增加1807元/例,多获得的QALY为0.014,ICER为127635元/QALY。当TAAb筛查费高于889.552元,或贴现率高于0.068,或抗病毒治疗依从性低于45.1%时,ICER>212676元/QALY。单次TAAb筛查费为400~600元时,TAAb+AFP策略具有成本效果价值。当支付意愿为70892、141784和212676元/QALY时,TAAb+AFP策略具有成本效果的概率分别为70.6%、75.3%和77.8%。结论对中国CHB肝硬化人群采用TAAb+AFP策略进行肝癌早期筛查具有成本效果价值。
