摘要
目的 了解维持性血液透析者（MHD）乙肝和丙肝病毒感染率及其影响因素。方法 抽取山西省某血液透析中心维持性血液透析患者187例进行问卷调查,同时抽取其空腹静脉血使用电化学发光分析仪定量检测乙肝5项和抗-HCV水平。结果 187例维持性血液透析者中HBsAg阳性率为3.7%,HBV感染率为27.8%,HCV阳性率为9.6%,联合感染HBV和HCV阳性率为4.8%;不同婚姻状况、丙肝感染情况的MHD患者HBV-M感染率差异有统计学意义（P〈0.05）;anti-HBc是否阳性、有无肾移植史、不同拔牙、既往手术外伤史和透析年限MHD患者HBV-M感染率差异有统计学意义（P〈0.05）;多因素logistic回归分析结果显示,丙肝是感染HBV的独立危险因素（OR=2.930,95%CI=1.092-7.860）;Anti-HBc阳性（OR=3.496,95%CI=1.014-12.057）、有肾移植史（OR=8.064,95%CI=2.197-29.601）和拔牙（OR=8.170,95%CI=2.255-29.603）是血透患者感染HCV的独立危险因素。结论 维持性血液透析者HCV感染率较高,应针对危险因素采取严格的消毒和血液筛查措施以降低其感染率。
Objective To examine the prevalence rates of hepatitis B virus（HBV） and hepatitis C virus（HCV） infection and to explore influencing factors of the infection among hemodialysis patients.Methods A total of 187 hemodialysis patients from a hemodialysis unit in Shanxi province were investigated with a self-designed questionnaire.Meanwhile,fasting venous blood samples of the patients were collected for HBV and HCV test with automatic chemiluminescence analyzer.Results Among the patients,the positive rate of HBV surface antigen and antibody to HCV were 3.7% and 9.6% respectively,but the infection rate of HBV was 27.8%.Besides,the co-infection rate of HBV/HCV was 4.8%.Single factor analysis showed that the infection of HBV was associated with marriage status and HCV infection was associated with the infection of HBV（P=0.046 and P=0.027）.The infection rate of HBV for married men and anti-HCV positive persons were 30.4% and 50.0%,respectively.The analyses also revealed that factors relating to the infection of HCV included history of anti-HBV core（anti-HBC） positive,kidney transplantation,operation or trauma,and dental surgery,with the HCV infection rate of 22.2%,37.5%,35.35,and 16.9% and p values of 0.042.000,0.001,and 0.011,respectively.The HCV infection rate was elevated with the duration of dialyisis and the infection rate was up to 19.2% for the patients with the dialysis of more than 3 years.Multivariate analyses indicated that the risk factors for HBV infection was HCV infection（odds ratio[OR]=2.930）,and the risk factors of HCV infection were anti-HBc positive（OR=3.496,95% confidence interval[95%CI]：1.014-12.057）,with the history of kidney transplantation（OR=8.064,95%CI：2.197-29.601）,and dental surgery（OR=8.170,95%CI：2.255-29.603）,respectively.Conclusion The prevalence rate of HCV infection is high in hemodialysis patients,suggesting that strict disinfection and blood screening measures need to be taken for reducing HCV infection.
出处
《中国公共卫生》
CAS
CSCD
北大核心
2013年第11期1577-1580,共4页
Chinese Journal of Public Health
基金
国家"十二五"艾滋病和病毒性肝炎等重大传染病防治专项(2012ZX10002001-003)
关键词
血液透析
乙型肝炎病毒
丙型肝炎病毒
感染率
危险因素
hemodialysis
hepatitis B virus （HBV）
hepatitis C vires （HCV）
prevalence risk factor
