Nishikado T, Honda H, Kamamura M, Hibino S, Ito S
2nd Department of Internal Medicine, School of Medicine, University of Tokushima, Japan.
Tokushima J Exp Med. 1996 Jun;43(1-2):25-37.
After adaptation of the second-generation anti-hepatitis C virus (HCV) test, the incidence of post-transfusion hepatitis (PTH) resulted in 5.2% (11/208), which was significantly lower than that 10.5% (22/209) demonstrated by screening donor blood for C100-3 antibody. The 11 cases of PTH, three were classified as definite PTH and the other were as suspected one. Of two cases with definite PTH and two cases with suspected PTH, their blood samples after transfusion became positive for HCV-RNA, and three cases of those showed a second peak of alanine aminotransferase (ALT) more than 4 weeks after operation. On the other hand, of seven cases containing one definite PTH, their blood samples after transfusion became negative for HCV-RNA, and five cases of those showed ALT peaks within 4 weeks after operation, and returned to normal levels of ALT thereafter. Moreover, in cases of definite PTH, the periods of surgery and anesthesia were longer and the volume of bleeding was much more during operation than in cases of suspected PTH, although the differences were not statistically significant. These findings suggested that cases of PTH include those of transient liver disease attributable to surgery as well as those of HCV infection. In 11 cases of PTH, we consider that 2 cases is true PTH, because these are HCV-RNA positive and have second peak more than 4 weeks after operation and 5 cases is questionable by clinical date. Thus new diagnostic criteria should have established.
在采用第二代抗丙型肝炎病毒（HCV）检测方法后，输血后肝炎（PTH）的发生率为5.2%（11/208），显著低于通过检测供血者血液中C100 - 3抗体所显示的10.5%（22/209）。11例PTH中，3例被归类为确诊PTH，其余为疑似PTH。在2例确诊PTH和2例疑似PTH病例中，输血后的血样HCV - RNA呈阳性，其中3例在术后4周以上出现丙氨酸氨基转移酶（ALT）的第二个峰值。另一方面，在包含1例确诊PTH的7例病例中，输血后的血样HCV - RNA呈阴性，其中5例在术后4周内出现ALT峰值，随后ALT恢复到正常水平。此外，在确诊PTH的病例中，手术和麻醉时间比疑似PTH的病例更长，术中出血量也更多，尽管差异无统计学意义。这些发现表明，PTH病例包括由手术引起的短暂性肝病病例以及HCV感染病例。在11例PTH中，我们认为2例为真正的PTH，因为这些病例HCV - RNA呈阳性且术后4周以上出现第二个峰值，另外5例根据临床数据存疑。因此，应建立新的诊断标准。
