血液透析患者丙型肝炎病毒感染的预防

目的 调查血透患者丙肝病毒(HCV)感染情况及影响因素，探讨预防HCV感染的措施。方法 在未采取HCV感染预防措施的1990—1992年间、采取HCV感染预防措施的1997—1999年间及使用一次性透析器后的2001—2002年间，采用日本Kuraray公司提供的抗HCV—14试剂盒，以间接酶免疫测定法检测长期维持性血透患者抗体。结果 HCV的1年阳转率1991—1992年为42．2％，1998—1999年为22．8％，2001年--2002年为9％；输血量越多，透析时间越长，丙肝的感染率越高。结论 多次输血是血透患者高丙肝病毒感染的主要原因，透析过程中的医院感染也是不容忽视的重要因素。减少输血量，加强对血透患者HCV感染者的管理，严格消毒隔离，透析器一次使用等可有效控制血液透析(HD)患者高HCV感染状态。

HCV Infection in Hemodialysis Patients: Investigation and Prevention

OBJECTIVE To investigate the state of HCV infection in maintenance hemodialysis patients and discuss the prevention strategies of HCV infection. METHODS HCV antibodies in serum of hemodialysis patients in 1990-1992 which were tested with indirect enzyme immunoassays provided by Kuraray Company, Japan, the prevention methods were not taken, and the patients in 1997-1999 which the prevention methods were taken and the patients in 2001-2002 with applying disposable dialyzer. RESULTS The results showed the infection rate of HCV was 42.2% form 1991 to 1992, 22.8% from 1998 to 1999, 9% from 2001 to 2002.CONCLUSIONS The main cause of HCV infection was repeated blood transfusion, but nosocomial transmission in hemodialysis units also played an important role. Decreasing the times of blood transfusion, isolating HCV infected patients, and applying disposable dialyzer can partially reduce the transmission of HCV among hemodialysis patients.