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[血友病患者的乙型肝炎病毒和巨细胞病毒血清学标志物]

[Serological markers of hepatitis B virus and cytomegalovirus in patients with hemophilia].

作者信息

Kacperska E, Głoskowska-Moraczewska Z, Seyfried H, Kolasińska-Kramer M, Cetnarowicz H, Lopaciuk S

机构信息

Zakładu Serologii, Instytutu Hematologii w Warszawie.

出版信息

Acta Haematol Pol. 1990 Jan-Jun;21(1):52-9.

PMID:2175533
Abstract

In 100 adult patients with severe haemophilia A (78 patients) and B (22 patients) sera were screened for the presence of serological markers of hepatitis B virus (HBV) and of cytomegalovirus (CMV) and liver function tests were performed which included measurement of serum aminotransferase AST and ALT activities, total bilirubin concentration and plasma levels of factor VII and X. In all the patients at least one out of five determined HBV markers (HBsAg. HBeAg, anti-HBs, anti-HBc and anti-HBe) was detected. HBsAg was found in 10% of the patients, and its prevalence in haemophiliacs B was higher than than observed in haemophiliacs A (22.7% and 6.4%, respectively). HBsAg appeared more frequently in patients receiving factor VIII concentrates (16.7%) than in those treated with cryoprecipitate (4.5%). Anti-CMV antibody was detected in sera of 98% of the patients. In 1/3 samples of cryoprecipitate anti-HBc or anti-HBs were present, and in the half of samples anti-CMV occurred. Abnormal liver function tests indicating chronic hepatitis or liver cirrhosis were obtained in 8 patients. Raised ALT activity which could suggest chronic infection with non-A, non-B virus occurred in 6 cases. The present study indicates that haemophiliacs frequently transfused with plasma products are at high risk for viral infections leading to liver dysfunction.

摘要

对100例成年重度甲型血友病患者(78例)和乙型血友病患者(22例)的血清进行筛查,检测乙肝病毒(HBV)和巨细胞病毒(CMV)的血清学标志物,并进行肝功能检查,包括测定血清转氨酶AST和ALT活性、总胆红素浓度以及因子VII和X的血浆水平。在所有患者中,所检测的五项HBV标志物(HBsAg、HBeAg、抗-HBs、抗-HBc和抗-HBe)中至少有一项被检测到。10%的患者检测到HBsAg,其在乙型血友病患者中的患病率高于甲型血友病患者(分别为22.7%和6.4%)。接受VIII因子浓缩物治疗的患者中HBsAg出现频率(16.7%)高于接受冷沉淀治疗的患者(4.5%)。98%的患者血清中检测到抗-CMV抗体。在1/3的冷沉淀样本中存在抗-HBc或抗-HBs,在一半的样本中存在抗-CMV。8例患者肝功能检查异常,提示为慢性肝炎或肝硬化。6例患者ALT活性升高,可能提示非甲非乙型病毒慢性感染。本研究表明,频繁输注血浆制品的血友病患者发生导致肝功能障碍的病毒感染风险很高。

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