维持性血液透析患者病毒性肝炎感染分析

目的了解维持性血液透析患者病毒性肝炎感染情况及危险因素,探讨预防血液透析患者感染病毒性肝炎的措施。方法对2009～2011年中国医科大学附属第一医院肾内科血液透析室的125例维持性血液透析患者,采用化学发光法检测丙型肝炎病毒(HCV)抗体及乙型肝炎6项,回顾分析维持性血液透析患者的临床资料。结果 125例维持性血液透析患者肝炎病毒感染率分别为乙型肝炎病毒(HBV)23.2%,丙型肝炎病毒5.6%。不同年龄和性别在病毒性肝炎感染率差异无显著性(P>0.05),HBV感染组、非感染组在输血次数差异无显著性(P>0.05),在透析时间差异具有显著性(HBV感染组60.1±25.7月比非感染组43.0±25.3月,P<0.01)。HCV感染组、非感染组在输血次数(HCV感染组85.7%vs.非感染组15.7%,P<0.05)、透析年限(HCV感染组65.9±35.9月比非感染组43.0±25.3月,P<0.05)的差异均有显著性。结论血液透析患者是肝炎病毒感染的高危人群,乙型肝炎感染率在输血次数的差异无显著性,与透析年限的差异有显著性,丙型肝炎感染率随输血次数及血液透析时间的延长而增高。严格隔离可以预防医院内交叉感染的发生。

Analysis of virus hepatitis infection in maintenance hemodialysis patients

Objective To observe the prevalence of virus hepatitis infection in maintenance hemodialysis (MHD) patients, and to investigate the methods to prevent and control virus hepatitis infection in dialysis unit. Methods A total of 6 assays for the detection of antibodies for HCV and antibodies and antigens for hepatitis B were performed by chemiluminescence immunoassay method in 125 MHD patients on regular hemodialysis for more than one year (2009-2011). Clinical data were analyzed retrospectively. Results The incidence of HBV hepatitis and HCV hepatitis in MHD patients were 23.2% and 5.6%, respectively, without significant correlation of the incidences with age or gender (P> 0.05). For HBV infection, there was no difference in blood transfusion times between positive infection group and negative infection group (P> 0.05), but there was significant difference in hemodialysis age between positive infection group and negative infection group (60.1±25.7 months in the former group, and 43.0±25.3 months in the latter group, P< 0.01). For HCV infection, positive infection group and negative infection group showed significant differences in blood transfusion times (85.7% in the former group, and 15.7% in the latter group, P < 0.05) and hemodialysis age (65.9±35.9 months in the former group and 43.0±25.3 months in the latter group, P < 0.05). Conclusion MHD patients are at high risk to infection of hepatitis viruses. The incidence of HBV infection increases in MHD patients with longer hemodialysis age, but seems to be unrelated to blood transfusion times. The chance of HCV infection increases in patients with multiple blood transfusion and longer hemodialysis age. Strict isolation procedures must be carried out to prevent HBV and HCV cross-infection in dialysis unit.