内窥镜检查、手术、输血前5969例患者HBV、HCV、HIV、梅毒螺旋体抗体检测结果

目的了解内蒙古医学院附属人民医院2006—2008年度内窥镜检查、手术、输血前患者HBV、HCV、HIV、梅毒螺旋体4种病原体的感染情况,为更好地预防和控制感染提供依据。方法对5969例患者血清采用ELISA检测乙型肝炎病毒血清标志物（HBVM）、丙型肝炎病毒抗体（抗-HCV）、艾滋病病毒抗体（抗-HIV）,采用甲苯胺红不加热血清试验TRUST及ELISA检测梅毒螺旋体抗体（抗-TP）。结果 5969例患者中,乙肝表面抗原（HBsAg）阳性患者144例,抗-HCV阳性患者65例,抗-HIV阳性患者末检出,抗-TP阳性患者9例。其阳性检出率分别为2.41%、1.09%、0、0.15%,其中孕妇HBsAg阳性7例,抗-HCV阳性2例。HCV感染率逐年上升,2008年与2006年相比较,存在显著性差异。254例内窥镜检查前患者传染性标志物的阳性检出率均较5715例手术、输血前患者的检出率高。HBVM模式中,HBsAg阳性组共检出6组,其中以HBsAg＋、HBeAg＋、抗-HBc＋及HBsAg＋、抗-HBe＋、抗-HBc＋两种模式为主,分别占13.19%、67.36%。结论为了使医院感染控制工作更加完善,在做好患者手术、输血前传染性标志物检测的同时,也应严格做好患者内窥镜检查前传染性标志物的检测,并且HBV感染的检测应由单一的HBsAg检测增为HBVM的检测,为临床预防和控制感染提供更全面、更可靠的依据。

Test Results of HBV, HCV, HIV, Treponema pallidum Antibodies of Patients before Receiving Endoscopy, Surgery and Blood Transfusion

Objective]To understand the prevalence of HBV,HCV,HIV,syphilis pathogens among patients before receiving endoscopy,surgery and blood transfusion in Inner Mongolia Medical College Affiliated People＇s Hospital during 2006—2008,and provide evidence for prevention and control of infections.Methods]ELISA method was used to detect serum hepatitis B virus markers（HBVM）,hepatitis C virus antibody（anti-HCV）,HIV antibody（anti-HIV） of 5969 patients,toluidine red unheated TRUST and ELISA serum test were used to detect Treponema pallidum antibody（anti-TP）.Results]Of 5969 cases,144 patients were surface antigen（HBSAg） positive,65were anti-HCV positive patients,anti-HIV positive patient was not detected,9 were anti-TP positive patients.The positive detection rate was 2.41%,1.09%,0.015%,respectively.7 cases of pregnant women were HBsAg positive,2 were anti-HCV-positive.HCV infection rate increased annually,the difference was significant between 2006 and 2008.The positive rate of infectious markers of 254 patients before receiving endoscopy was higher than those of 5705 patients before receiving surgery and blood transfusion.Of patients with HBVM detection,HBsAg-positive were found in 6 groups,of which the HBsAg＋、HBeAg＋、anti-HBc and HBSAg＋、anti-HBe＋、anti-HBc were the main 2 modes,which accounted for 13.19% and 67.36% respectively.Conclusion]In order to make hospital infection prevention and control work more complete,it is necessary to implement infectious markers detection before patients receiving surgery,blood transfusion and endoscopy,and to perform HBVM detection instead of single detection of HBsAg for detection of HBV infection,so as to provide more comprehensive,and reliable evidence for clinical prevention and control of infection.