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[心脏手术中输血后非甲非乙型肝炎的发生情况。关于献血者血清丙氨酸转氨酶测定及抗-HBc抗体检测价值的前瞻性研究]

[Occurrence of non-A, non-B post-transfusion hepatitis in heart surgery. Prospective study on the value of the determination of serum alanine aminotransferase and detection of anti-HBc antibodies in blood donors].

作者信息

Gayet S, Aymard J P, Janot C, Guillemin C, Briquel M E, Gaucher P, Streiff F

出版信息

Rev Fr Transfus Immunohematol. 1986 Dec;29(6):485-94. doi: 10.1016/s0338-4535(86)80079-4.

Abstract

We studied a group of 64 patients undergoing cardiac surgery for the occurrence of post-transfusion hepatitis during a follow-up period of 5 months. They received blood units (packed red cells in saline-adenine-glucose medium and/or fresh frozen plasma exclusively) from 447 volunteer donors. Post-transfusion hepatitis was identified in 5 patients: 1 patient had cytomegalovirus hepatitis and the remaining 4 cases were defined, by exclusion, as non-A, non-B hepatitis (with prevalence and incidence rates of 80% and 6.25% respectively). We found no statistically significant differences between the numbers of transfused blood product units in patients who developed non-A, non-B hepatitis as compared to those who did not. Our analysis of the predictive effectiveness of alanine aminotransferase and anti-HBc antibodies screening in blood donors to prevent non-A, non-B post-transfusion hepatitis led to the following conclusions: we failed to confirm the association between anti-HBc in blood donors and enhanced risk of non-A, non-B hepatitis in recipients since no case developed among patients receiving blood products from anti-HBc positive donors. So, 20 donors (4.5%) would have been discarded without any reduction of the incidence of non-A, non-B hepatitis. we could not confirm nor exclude the possibility that screening donor blood for elevated alanine aminotransferase levels would have reduced the number of non-A, non-B hepatitis in recipients.

摘要

我们研究了一组64例接受心脏手术的患者,在5个月的随访期内观察输血后肝炎的发生情况。他们接受了来自447名志愿供血者的血液成分(仅为生理盐水 - 腺嘌呤 - 葡萄糖培养基中的浓缩红细胞和/或新鲜冰冻血浆)。5例患者被确诊为输血后肝炎:1例为巨细胞病毒性肝炎,其余4例经排除后被定义为非甲非乙型肝炎(患病率和发病率分别为80%和6.25%)。我们发现发生非甲非乙型肝炎的患者与未发生该疾病的患者相比,所输注的血液制品单位数量无统计学显著差异。我们对供血者丙氨酸转氨酶和抗 - HBc抗体筛查对预防非甲非乙型输血后肝炎的预测有效性进行分析后得出以下结论:我们未能证实供血者抗 - HBc与受血者非甲非乙型肝炎风险增加之间的关联,因为接受抗 - HBc阳性供血者血液制品的患者中未出现病例。因此,20名供血者(4.5%)本可被排除,但非甲非乙型肝炎的发病率并未降低。我们既不能证实也不能排除对供血者血液进行丙氨酸转氨酶水平升高筛查会减少受血者中非甲非乙型肝炎病例数的可能性。

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