湘南地区住院患者丙型肝炎病毒感染方式的特征分析

目的 了解湖南地区住院患者中HCV疑似感染方式分布的规律特征,为HCV感染的防治提供参考.方法 应用电子病历查询法对住院患者中诊断有丙型肝炎者进行回顾性分析.化学发光法检测抗HCV抗体,实时荧光定量PCR法检测HCV RNA定量.结果 肾内科患者主要经血液透析感染(80.0％),妇产科患者主要经手术感染(64.7％),感染科患者主要为输血感染(39.0％)和静脉吸毒感染(28.6％),其他科室患者也主要为输血感染(40.7％)和静脉吸毒感染(37.0％),不同科室住院患者的HCV疑似感染方式构成比存在明显差异(P＜0.01).年龄≤40岁患者主要经静脉吸毒感染( 38.2％),而年龄＞40岁患者主要经输血感染(49.3％),不同年龄患者HCV疑似感染方式构成比存在明显差异(P＜0.01).男性患者主要经静脉吸毒(35.0％)和输血感染( 32.5％),而女性患者主要经手术(32.7％)和输血( 26.9％)感染,不同性别患者HCV疑似感染方式构成比存在明显差异(P＜0.01).结论 HCV的感染方式已呈现明显的多样化,静脉吸毒将成为越来越重要的感染因素.

Mode of acquisition of hepatitis C virus infection in patients from southern Hunan province hospitalized with chronic hepatitis C

Objective To investigate the characteristics of hepatitis C virus(HCV) infection mode of acquisition in hospitalized patients with chronic hepatitis C(CHC),and to provide a reference for designing preventative measures against CHC.Methods The electronic medical records of patients diagnosed with HCV and hospitalized between January 2005 and December 2011 were retrospectively identified and downloaded for analysis.Measurements of anti-HCV,by chemiluminescence assay,and serum HCV RNA,by real-time quantitative RT-PCR.Data on the department of treatment,clinical and demographic features,and lifestyle risk factors were extracted.Results The most frequent clinical feature of patients treated in the Nephrology Department was hemodialysis(80.0%),in the Obstetrics and Gynecology Department was surgery(64.7%),and in the Infectious Diseases Department was blood transfusion(39.0%) followed closely by intravenous drug abuse(28.6%).In the other departments(collectively pooled),blood transfusion(40.7%) and intravenous drug abuse(37.0%) were the most frequent.The differences in rates of the most frequent clinical features from among the four groups of hospital departments were statistically significant(P<0.01).The most frequently reported cause of infection for patients aged 40 years or younger was intravenous drug use(38.2%),while patients over 40 were mainly infected by blood transfusion(49.3%);for both cuases,the differences in rates between the two age groups were statistically significant(P<0.01).Male patients were mainly infected by intravenous drug use(35.0%) and blood transfusion(32.5%),while female patients were mainly infected by surgery(32.7%) and blood transfusion(26.9%);for these four causes,the differences in rates between the two sex groups were statistically significant(P<0.01).Conclusion The mode of HCV infection among the population stratified by age and sex shows clear diversification.Intravenous drug abuse appears to be an important infection route for younger individuals and males.