维持性血液透析患者隐匿性乙型肝炎病毒感染的调查与分析

发布时间：2018-06-30 20:48

本文选题：维持性血液透析 + 隐匿性乙型肝炎病毒感染　；参考：《肾脏病与透析肾移植杂志》2017年05期

【摘要】：目的:旨在评估维持性血液透析(MHD)患者中隐匿性乙型肝炎病毒(HBV)感染(OBI)情况。方法:对2014年12月至2015年12月四川省人民医院血液透析中心的MHD患者采用ELISA法检测HBV标记物,并对HBs Ag(-)/HBc Ab(+)患者进行实时定量荧光PCR(real-time PCR)检测HBV-DNA,了解OBI的患病率。结果:(1)入选本中心MHD患者330例,平均年龄60.66±14.32岁,男性55.7%,女性44.3%;HBV患病率为7.3%(24/330),54.5%(180/330)为既往感染过HBV[HBs Ag(-)/HBc Ab(+)];(2)共收集到165例既往感染过HBV患者的血浆标本进行HBV-DNA检测,发现7例阳性,水平均很低(20 IU/ml),所以OBI的患病率对于进行检测的患者来说为4.2%(7/165),对于整个透析中心患者来说为2.2%(7/315);(3)将7例OBI患者作为观察组,剩下158例HBV-DNA(-)患者作为对照组进行比较发现,男性OBI比例更高(P=0.042),疫苗接种可预防OBI(P=0.010);(4)单一HBc Ab(+)患者(6.5%)比HBc Ab(+)/HBs Ab(+)患者(3.8%)具有更高的OBI患病率,但两者间无明显统计学差异(P=0.617)。结论:本组MHD患者中54.5%既往感染过HBV,目前OBI患病率为2.2%,且HBV-DNA水平低下,但仍有引起病毒传播的风险,特别是单一HBc Ab(+)患者。
[Abstract]:Objective: to evaluate the occult hepatitis B virus (HBV) infection (Obi) in maintenance hemodialysis (MHD) patients. Methods: HBV markers were detected by Elisa in hemodialysis center of Sichuan Provincial people's Hospital from December 2014 to December 2015. HBV-DNA was detected by real-time quantitative fluorescence PCR (real-time PCR) in patients with HBs Ag (-) / HBc Ab (). Results: (1) 330 MHD patients (mean age: 60.66 卤14.32 years old) were enrolled in this study. The prevalence rate of HBV-DNA in women was 7.3% (24 / 330) or 54.5% (180 / 330). The prevalence rate of Obi was 4.2% for the patients tested, 2.2% for the whole dialysis center patients (7 / 315); (3), and 7 cases for Obi patients as the observation group, and the remaining 158 cases for HBV-DNA (-) as the control group. The proportion of male Obi was higher (P0. 042). The incidence of Obi was higher in single HBc Ab () patients (6.5%) than in HBc Ab () / HBs Ab () patients (3. 8%), but there was no significant difference between the two groups (P0. 617). Conclusion: 54.5% of MHD patients had been infected with HBV in the past. The prevalence of Obi was 2.2 and the level of HBV-DNA was low, but there was still a risk of virus transmission, especially in patients with single HBc Ab ().
【作者单位】：四川省医学科学院·四川省人民医院肾脏内科;
【基金】：中国医院协会课题(CHABP2016-12)
【分类号】：R459.5;R512.62

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