维持性血液透析患者肝炎病毒感染发生情况及原因分析

目的调查分析维持性血液透析患者病毒感染情况及相关因素。方法收集于解放军总医院肾内科行维持性血液透析的163例患者的临床资料,观察乙型肝炎病毒(hepatitis B virus,HBV)及丙型肝炎病毒(hepatitis C virus,HCV)感染情况并分析其与透析时间、肾移植史、外科手术史及输血的关系。结果纳入研究的163例患者中,感染HBV的患者18例(11.0%),感染HCV的患者14例(8.6%)。感染HCV患者的透析龄最长,为(79.0±51.6)月,同时,感染HCV的患者肾移植病史及外科手术史比例也高于其他两组患者。分析HCV及HBV首次发现时间,患者感染HCV多发生在肾移植术后,感染HBV多发生于透析开始前,而发生在透析间期的比例不高。结论血液透析患者中,感染HCV与HBV患者的比例无明显差异,但感染HCV的患者多继发于肾移植、手术及输血,而感染HBV的患者多为原发。因此,加强对血液透析患者继发感染HCV的控制十分重要。

The prevalence and cause of hepatitis virus infections in maintenance hemodialysis patients

Objective To investigate the prevalence and cause of hepatitis B virus （HBV） and hepatitis C virus （HCV） infections in patients on maintenance hemodialysis （MHD）. Methods Clinical data of the 163 MHD patients was recruited. The prevalence of hepatitis virus infections was analyzed in association with the duration of hemodialysis and the history of renal transplantation, surgery and blood transfusion. Results Eighteen patients （11. 0%） were infected with HBV, and 14 patients （8.6%） with HCV. Patients with HCV infection usually had longer hemodialysis durations （79.0±51.6 months）. A large part of the patients with HCV infection had the history of renal transplantation （6/14） or were detected before hemodialysis （7/14）. In contrast, most HBV infections were found before hemodialysis （17/18）. Conclusion The proportion of HCV and HBV infections was similar in MHD patients. Most HCV infections occurred after renal transplantation, surgery or blood transfusion, but most HBV infections were primary ones.