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目的 追踪观察发生HCV感染的献血者的疾病进程和健康状况。方法 从 1993年 10月～ 2 0 0 4年 2月 ,对 30名HCV感染的献血者定期抽取血液标本 ,观察所得到的 4 4 2份系列标本的血清ALT、抗 HCV和HCV RNA的动态变化 ,并进行HCV分型测定 ,重点分析了其中 10名自愿者肝组织的病理检查结果和血清ALT、抗 HCV与HCV RNA的动态变化。结果 ① 30名HCV感染者系列标本中 ,ALT异常率 37.6 % (16 6 / 4 4 2 ) ;抗 HCV阳性率97.1% (42 9/ 4 4 2 ,ELISA法 ) ;HCV RNA阳性率 74 .9% (331/ 4 4 2 )。② 10名HCV感染的献血者 10年系列血清中抗 HCV大多数持续存在 (94 4 % ,15 1/ 16 0 ) ,其HCV RNA时有间隙性阴性 ,阳性率 6 7 5 % (10 8/ 16 0 )其血清ALT水平异常率 33 6 % (5 0 / 14 9)。③HCV分型测定 :HCVⅡ / 1b型占 85 % (2 2 / 2 6 ) ,Ⅲ / 2a型占 15 % (4/ 2 6 )。④ 10名HCV感染者肝组织检查显示均为轻度慢性肝炎。结论 肝组织的病理变化同血清抗 HCV、HCV RNA和ALT的异常有明显相关性。虽然HCV感染后 10年的疾病进程大多是缓慢的 ,但应采取适当治疗措施以控制慢性肝炎的发展。
OBJECTIVE To follow up the course of disease and health status of blood donors with HCV infection. Methods From October 1993 to February 2004, blood samples were collected from 30 blood donors with HCV infection. The serum ALT, anti-HCV and HCV RNA in 442 samples were observed. , And HCV genotyping was performed. The pathological results of hepatic tissue in 10 volunteers and the dynamic changes of serum ALT, anti-HCV and HCV RNA were analyzed. Results ① The abnormality rate of ALT was 37.6% (16 6/4 4 2) among 30 HCV infected patients. The positive rate of anti-HCV was 97.1% (42 9/4 4 2, ELISA) and the positive rate of HCV RNA was 74.9 % (331/4 4 2). ② The majority of anti-HCV in 10-year-old serum of 10 HCV-infected donors persisted (94 4%, 15 1/160) and had a negative cytopathogenicity with a positive rate of 67.5% (108% The abnormal rate of serum ALT level was 33 6% (50/14 9). HCV genotyping: HCV Ⅱ / 1b accounted for 85% (2 2/2 6), Ⅲ / 2a accounted for 15% (4/2 6). ④ 10 HCV infected liver tissue examination showed mild chronic hepatitis. Conclusion The pathological changes of liver tissue are obviously correlated with the abnormalities of serum anti-HCV, HCV RNA and ALT. Although most of the 10-year disease progression after HCV infection is slow, appropriate treatment should be taken to control the development of chronic hepatitis.