输血后肝炎的临床研究

利用血清学ＥＬＩＳＡ法和ＰＣＲ技术对１６９名输血后肝炎（ＰＴＨ）患者的病原学进行了研究。结果表明，ＰＴＨ主要致病原为ＨＣＶ（９８．２２％），其中部分患者（１４．０２％）同时合并有ＨＢＶ感染，３例ＰＴＨ病因尚不明确，有待进一步研究。ＨＣＶ所致ＰＴＨ患者抗ＨＣＶ检出时间为ＰＴＨ症状出现后７ｄ～１年，平均为５４．６２ｄ。ＨＣＶＲＮＡ在感染早期（６～２０ｄ，平均８．７２ｄ），即可检出。对８４名ＰＴＨ患者１．５～３年内抗ＨＣＶ和ＨＣＶＲＮＡ动态观察的结果表明，抗ＨＣＶ可较长时间持续存在，而ＨＣＶ病毒血症可有３种表现形式：一过性病毒血症、持续性病毒症和间歇性病毒血症。本研究证实，认真开展献血者抗ＨＣＶ筛查对于减少或防止ＰＴＨ发生十分重要；另外，医务人员应严格掌握输血指征，严禁无指征输血。

Clinical Study of Posttransfusion Hepatitis

patients with posttransfusion hepatitis (PTH) were investigated for clinical characteristics of etiology with serological ELISA and PCR methods. The result showed that 166 of them (98.22%) were anti-HCV and/or HCV RNA positive. 24 of them were HBsAg positive too,none of them was anti-HAV IgM or anti-HEV positive. 3 patients who were negative for all viral markers need further studying. Anti-HCV was detectable from 7 days to one year after onseting of clinical symptoms ,average time 54. 62 days. HCV RNA could be detected in early time of HCV infection(6 to 20 days later),average time 8. 72 days. A follow-up study of 84 PTH patients caused by HCV infection showed that all patients remained anti-HCV positive during the observing(1. 5～3 years), but their HCV viremia had three forms: transient, persistent or interminant. This study suggested that all blood donors must be screened carefully with both HBV and HCV diagnostic kits,only ones with clear indications could be transfused.