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[慢性血液透析患者中抗丙型肝炎病毒抗体的患病率]

[The prevalence of anti-hepatitis virus C antibodies in chronic hemodialysis patients].

作者信息

Camps D H, Azcona S, Bertola S, Kohn I, Noguera E, Garzón Maceda F, Bongiorno E, Massari P, De Arteaga J

机构信息

Servicio de Gastroenterología, Hospital Privado, Córdoba, Argentina.

出版信息

Medicina (B Aires). 1992;52(6):511-5.

PMID:1340899
Abstract

Liver involvement with a variety of viral diseases is a frequent finding in chronic renal failure patients on regular hemodialysis treatment. We evaluated the prevalence of IgG anti-hepatitis C virus antibodies (HVC) in our dialysis unit, looking for risk factors associated with seropositivity and we assessed the type and degree of liver involvement by means of a liver biopsy in those patients with biochemical abnormalities of liver function test. We studied 50 patients aged 13 to 77 years, and performed serial determinations of serum ALT (UI/L). IgG anti HVC was determined by a second generation ELISA Kit (Abbot). We retrieved information from chart review and patient interview, regarding: time on hemodialysis, number of blood transfusions and intravenous IV drug use off dialysis. Liver biopsy specimens were stained with H.E. and Masson and findings were classified as chronic persistent, chronic active hepatitis or cirrhosis, according to Schewer. We compared the findings with those of other patients with liver dysfunction and positive IgG anti HVC who did not have renal failure. Anti-HVC prevalence in our hemodialysis patients was 44%. Anti-HVC seropositive hemodialysed (HD) patients were not different from seronegative HD patients, with regard to age, sex, i.v. drugs usage and peak ALT values. Twelve of 22 HVC positive patients had peak ALT values higher than 40 UI/L (Table 2). Time in HD (75.5 +/- 42.8 m) and number of blood transfusions received (35.3 +/- 28) were clearly different in HVC positive patients, compared to HVC negatives. Histologically, 11 seropositive patients showed chronic persistent hepatitis as the most frequent finding.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在接受定期血液透析治疗的慢性肾衰竭患者中,肝脏出现各种病毒性疾病是常见现象。我们评估了本透析单元中IgG抗丙型肝炎病毒抗体(HVC)的流行情况,寻找与血清阳性相关的危险因素,并通过肝活检对肝功能检查生化异常的患者评估肝脏受累的类型和程度。我们研究了50例年龄在13至77岁之间的患者,并对血清ALT(UI/L)进行了系列测定。IgG抗HVC通过第二代ELISA试剂盒(雅培)测定。我们从病历审查和患者访谈中获取了以下信息:血液透析时间、输血次数以及透析外静脉注射毒品使用情况。肝活检标本用苏木精-伊红(H.E.)和马松染色,根据舍韦尔的标准,将结果分类为慢性持续性肝炎、慢性活动性肝炎或肝硬化。我们将这些结果与其他肝功能不全且IgG抗HVC阳性但无肾衰竭的患者的结果进行了比较。我们血液透析患者中抗HVC的流行率为44%。抗HVC血清阳性的血液透析(HD)患者在年龄、性别、静脉注射毒品使用情况和ALT峰值方面与血清阴性的HD患者没有差异。22例HVC阳性患者中有12例ALT峰值高于40 UI/L(表2)。与HVC阴性患者相比,HVC阳性患者的血液透析时间(75.5±42.8个月)和接受输血的次数(35.3±28次)明显不同。组织学上,11例血清阳性患者最常见的表现为慢性持续性肝炎。(摘要截断于250字)

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