天津市某三甲医院维持性血液透析患者血源性病毒感染情况分析

【摘要】目的了解血液透析患者乙型肝炎病毒（hepatitisBvires，HBV）、丙型肝炎病毒（hepatitisCvirus，HCV）、人类免疫缺陷病毒humanimmunodeficiencyvirus，HIV）和梅毒螺旋体（treponemapal—lidum，TP）的感染情况。方法应用酶联免疫法检测449例维持性血液透析患者血清中HBV五项、抗-HCV、抗-HIV和TP抗体．应用PCR-荧光探针法检测HBsAg阳性的透析患者血清中HBV—DNA含量及抗-HCV阳性的透析患者血清中HCV—RNA含量，并进行统计学分析。结果449例透析患者HB．sAg、HBsAb、抗-HCV、TP抗体的阳性率分别为2．90％、20．71％、8．69％、1．78％，抗-HIV检测结果均为阴性。其中，HBsAg阳性患者中，HBV-DNA阳性率为46．15％，DNA拷贝数为1．1×104—3．7×10^7 IU／mL；抗-HCV阳性者中，HCV-RNA阳性率为58．97％，RNA拷贝数为8．1×10^3～1．5×10^7IU／mL。≥60岁和〈60岁两组患者HBsAg、抗-HCV阳性率比较，差异均无统计学意义（P均〉0．05）。结论血液透析患者HBV、HCV感染率相对国外较低，但感染现象在各年龄段普遍存在。TP感染情况与国内外报道相似，应加强管理防护。

Hematogenous virus infection situation in persistent hemodialysis patients from a top three hospital in Tianjin

Objective To learn the infection situation of hepatitis B virus （HBV）, hepatitis C virus （HCV）, human immunodeficiency virus （HIV） and treponema pallidum（TP） in hemodialysis patients. Methods The HBV, anti-HIV, anti-TP and anti-HCV in 449 persistent hemodialysis patients were detected by en- zyme-linked immunosorbent assay; the HBV-DNA content in HBsAg positive hemodialysis patients and the HCV-RNA content in anti-HCV positive hemodialysis patients were detected by the PCR-fluorescent probe assay. All data were analyzed by statistical analysis. Results The positive rates of HBsAg, HBsAb, anti- HCV and anti-TP in 449 hemodialysis patients were 2.90%, 20.71%, 8.69% and 1.78%, and the anti-HIV test results were all negative. Besides, the HBV-DNA positvie rates was 46.15% in HBV surface antigen posi- tive people, the DNA copy number was 1.1~104~3.7~107 IU/mL. The HCV-RNA positvie rates was 58.97% in anti-HCV positive people, the RNA copy number was 8.1x103~1.5 ~107 IU/mL. There were no signifcance differences in the positive rates of HBsAg, anti-HCV between /〉 60 and 〈 60 years old patients （Pall〉 0.05）. Conclusion HBV and HCV infection rates in this group hemodialysis patients are relatively low, but the phe- nomenon of infecion is widespread exist in all ages. TP infection is similar to that reported at home and abroad, should strengthen the management of protection.