输血相关性肝炎的临床与血清学分析

Clinical and serological analysis of transfusion-associated hepatitis.

作者信息

Alter H J, Holland P V, Morrow A G, Purcell R H, Feinstone S M, Moritsugu Y

出版信息

Lancet. 1975 Nov 1;2(7940):838-41. doi: 10.1016/s0140-6736(75)90234-2.

Abstract

Of 108 prospectively followed, multiply transfused, open-heart-surgery patients, 12 (11%) developed hepatitis. Patients received only volunteer donor blood tested for hepatitis-B surface antigen (HBsAg) prior to transfusion by counterelectrophoresis (C.E.P.). 4 of the 12 patients developed hepatitis-B-virus infection. Subsequent testing of donor serums by solid-phase radioimmunoassay (R.I.A.) revealed that an R.I.A.-positive, C.E.P.-negative blood unit was transfused to 3 of the 4 type-B hepatitis cases, but to none of the remaining 104 patients; 3 hepatitis-B cases could probably have been prevented by prescreening of donors by solid-phase R.I.A. 8 hepatitis cases were serologically unrelated to the hepatitis-B virus, the hepatitis-A virus, the cytomegalovirus, or the Epstein-Barr virus. Had R.I.A.-positive donors been excluded, 8 of the 9 residual hepatitis cases (89%) would have represented "non-A, non-B" hepatitis. The existence of previously unrecognised human hepatitis virus(es) is probable.

摘要

在108例接受前瞻性随访、多次输血的心脏直视手术患者中，有12例（11%）发生了肝炎。患者仅接受在输血前通过对流免疫电泳（C.E.P.）检测乙肝表面抗原（HBsAg）的志愿供血者的血液。这12例患者中有4例发生了乙肝病毒感染。随后通过固相放射免疫测定（R.I.A.）对供血者血清进行检测发现，在4例乙型肝炎病例中有3例输注了R.I.A.阳性、C.E.P.阴性的血液单位，而其余104例患者均未输注；通过固相R.I.A.对供血者进行预筛查，3例乙型肝炎病例可能得以避免。8例肝炎病例在血清学上与乙肝病毒、甲肝病毒、巨细胞病毒或爱泼斯坦-巴尔病毒无关。如果排除R.I.A.阳性的供血者，9例剩余肝炎病例中的8例（89%）将代表“非甲非乙”型肝炎。很可能存在以前未被识别的人类肝炎病毒。