血液透析患者血液中丙型及乙型肝炎病毒的检测

为了解血液透析患者血液中丙型肝炎病毒（ＨＣＶ）及乙型肝炎病毒（ＨＢＶ）的感染情况，对２２例维持性血液透析患者应用逆转录聚合酶链反应及酶联免疫吸附实验，检测了血清中ＨＣＶＲＮＡ及其抗体水平；同时采用斑点杂交及固相放射免疫法检测了血清中ＨＢＶＤＮＡ及其血清标志物。结果显示，２７％的血液透析患者血清ＨＣＶ抗体阳性，其中３３％的患者血清存在ＨＣＶＲＮＡ。在血清ＨＣＶ抗体阴性的１６例患者中，也有１例（６％）血清ＨＣＶＲＮＡ阳性。在２２例血液透析患者中，３例（１４％）血清ＨＢＶＤＮＡ阳性（ＨＢｅＡｇ也均阳性）。其余１９例ＨＢＶＤＮＡ阴性患者（ＨＢｅＡｇ均阴性），有１２例（６３％）血清抗－ＨＢｃ阳性。在７例血清ＨＣＶＲＮＡ或（和）抗－ＨＣＶ阳性者，５例有既往或现在ＨＢＶ感染的证据，但未见ＨＣＶＲＮＡ与ＨＢＶＤＮＡ同时存在者。提示在相当数量的血液透析患者体内存在肝炎病毒血症，应加强对血液透析患者肝炎病毒感染的监测及预防工作

DETECTIONOFSERUMHCVRNAANDHBVDNAINPATIENTSONHEMODIALYSIS

InordertoassesstherelationshipbetweenseropositivityandpotentialinfectivitycausedbyhepatitisCvirus(HCV)andhepatitisBvirus(HBV)inpatientsundergoingmaintenancehemodialy-sis,22patientsinourdialysisunitwereevaluatedbyusingnestedRT-PCRtodetectserumHCVRNA,ELISAtodetectserumanti-HCVantibodies,dotblottodetectserumHBVDNAandRIAtodetectHBVserummarkers.Twenty-sevenpercentofthepatients(6of22)wasanti-HCV-positive.Ofthe6anti-HCV-positivepatients,HCVRNAwasdetectedin2(33%)patients.Amongtheanti-HCV-nega-tivepatients,HCVRNAwasdetectedinone(6%)ofthe16patients.Fourteenpercent(3of22)wasHBVDNA-positive.Ofthe3HBVDNA-positivepatients,HBeAgwasdetectedinalofthem.AmongthenineteenHBVDNA-negativepatients,noHBeAgwasdetected,butanti-HBcwasdetectedin12(63%)ofthe19patients.FiveofthesevenpatientswithHCVinfection(HCV-Aband/orHCVRNA-positive)hadevidenceofadditionalpresentorpasthepatitisBvirusinfection(4ofthe5patientswereanti-HBc-positiveandoneofthe5wasHBVDNA,HBeAg,HBsAg,andanti-HBc-positive).Howev-er,noHCVRNAandHBVDNAwerefoundtocoexistinthesamepatientinthisstudy.Thesedatain-dicatethatmanypatientsonhemodialysishavehepatitisCorBviremiaandmoreattentionshouldbepaidtothisproblem.