维持血液透析的尿毒症病人乙型丙型肝炎病毒感染情况研究

目的　了解北京地区 (东城、宣武、朝阳区 )接受规律性血液透析患者 ,乙型肝炎病毒 (HBV)和丙型肝炎病毒 (HCV)的感染情况及其相关因素。方法　 1998年 3～ 12月在北京协和医院、朝阳医院等 4家医院血液净化中心 ,长期维持血液透析的尿毒症患者 2 2 5例 ,血透中心工作人员及健康献血者 5 0例为对照组。分别用PCR法和高敏PCR法检测HBVDNA、HCVRNA ,ELISA法检测乙肝两对半及丙肝抗体 ,并分析其与透析时间、输血、肝功能损害的关系。结果　 2 2 5例血液透析病人中 ,HCVRNA阳性 37例 (16 4 %) ;HBVDNA阳性 3例(1 33%)。多元回归分析表明 :输血和透析时间是丙型肝炎感染的危险因素。共有 3 0 %(3/ 99)的病人同时感染乙肝和丙肝 ,均有肝功能的损害和临床症状 ,8 1%(8/ 99)HBcAb阳性患者同时合并HCV感染。结论　血液透析病人乙肝和丙肝感染远高于对照组 ,透析时间和输血次数是丙肝感染的危险因素 ,HBV和HCV同时感染问题值得重视。

Hepatitis B and C virus infection in uremia patients on chronic hemodialysis

Objective To investigate the hepatitis C virus(HCV) and hepatitis B virus(HBV) infection in hemodialysis patients in several hemodialysis centers in Beijing.Methods HCV RNA,HBV DNA(PCR) and the serum virus antibody(ELISA) were detected in 225 uremia patients.50 volunteers and the employers in hemodialysis center were also as controls.The relationship between the infection of hepatitis virus and the dialysis time,blood infusion and hepatic function was analysed.Results 37 patients(16.4%) were positive in HCV RNA,3 patients(1.33%) positive in HBV DNA.The logistic analysis showed that blood infusion and the time of hemodialysis were the risk factors.3 patients(3/99,3.0%) were found to be infected with both hepatitis B and C,with disorder of liver function and clinical symptoms.8.1%(8/99) of patients with positive HBcAb were infected with HCV.Conclusion The prevalence of HCV infection in hemodialysis patients is serious.Hemodialysis time and times of blood transfusion are the major ways to transmit HCV.