湖北地区输血相关传染病交叉感染与重叠感染的研究
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摘要
目的对湖北及周边地区输血前患者进行输血相关传染病指标进行检测及分析,以了解患者的感染情况,从而避免或减少医疗纠纷,并为输血相关传染病,尤其是艾滋病及梅毒的防治提供参考依据。方法选取2011-2016年湖北及周边地区输血前患者60 570例作为研究组,同时选取2001-2003年湖北及周边地区输血前患者19 800例作为对照组,用化学发光法检测输血前患者人类免疫缺陷病毒(HIV)、乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)及梅毒螺旋体(TP)的血清标志物,比较不同时期输血前患者输血相关传染病的感染情况、传播途径与分布特点。结果研究组HIV阳性44例(0.07%),与对照组比较差异无统计学意义(P>0.05);TP阳性1 091例(1.80%),HBV阳性7 607例(12.56%),HCV阳性1 062例(1.75%),与对照组比较差异均有统计学意义(P<0.05)。研究组中HIV、TP双重感染8例,HIV、HBV双重感染10例,HIV、HCV双重感染4例;HIV、TP及HBV三重感染2例,HIV、TP及HCV三重感染4例,HIV、HBV及HCV三重感染1例,与对照组比较呈上升趋势(P<0.05)。结论湖北及周边的输血相关传染病感染情况仍旧严峻,某些患者在入院前就已感染了HIV、TP、HBV或HCV,少数患者甚至发生了双重或三重感染。临床应该进一步加强输血相关传染病,尤其是HIV与TP的预防和控制工作,减少输血相关传染病在普通人群中的传播。
Objective To analyze the results of serum makers of transfusion-related infectious diseases in Hubei Province and the surrounding areas,in order to understand the patient′s infection status,thereby avoiding or reducing medical disputes,and providing reference data for the prevention and treatment of transfusion-related infectious diseases,especially AIDS and syphilis.Methods 60 570 pretransfusion patients from 2011 to 2016 in Hubei Province and surrounding areas were selected as the study group.Meanwhile,19 800 pretransfusion patients from 2001 to 2003 in Hubei Province and surrounding areas were selected as control group.Chemiluminescence detection was used to examine human immunodeficiency virus(HIV),hepatitis B virus(HBV),hepatitis C virus(HCV)and treponema pallidum(TP)serum markers.Different period pretransfusion patients′infection status,route of transmission and distribution characteristics of transfusion-related infectious diseases were compared.Results In the study group,44 cases(0.07%)were HIV positive,and there was no statistical difference compare with the control group(P>0.05);1 091 cases were TP positive(1.80%),7 607 cases were positive for HBV(12.56%),and 1 062 cases were HCV positive(1.75%),and there were statistically significant differences compared with the control group(P<0.05).In addition,there were 8 cases of HIV and TP double infection,10 cases of HIV and HBV double infection,4 cases of HIV and HCV double infection;3 cases of HIV,TP and HBV triple infection,4 cases of HIV,TP and HCV triple infection,1 case of HIV and HBV,HCV triple infection in the study group;and compared with the control group,it showed an increasing trend(P<0.05).Conclusion The status of transfusion-related infectious diseases in Hubei Province and surrounding areas is still severe.Some patients have been infected with HIV,TP,HBV or HCV before hospitalization,and a few have even had double or triple infection.Clinic should further strengthen the prevention and control of transfusion-related infectious diseases,especially for HIV and TP,and reduce the spread of transfusion-related infectious diseases in the general population.
Objective To analyze the results of serum makers of transfusion-related infectious diseases in Hubei Province and the surrounding areas,in order to understand the patient′s infection status,thereby avoiding or reducing medical disputes,and providing reference data for the prevention and treatment of transfusion-related infectious diseases,especially AIDS and syphilis.Methods 60 570 pretransfusion patients from 2011 to 2016 in Hubei Province and surrounding areas were selected as the study group.Meanwhile,19 800 pretransfusion patients from 2001 to 2003 in Hubei Province and surrounding areas were selected as control group.Chemiluminescence detection was used to examine human immunodeficiency virus(HIV),hepatitis B virus(HBV),hepatitis C virus(HCV)and treponema pallidum(TP)serum markers.Different period pretransfusion patients′infection status,route of transmission and distribution characteristics of transfusion-related infectious diseases were compared.Results In the study group,44 cases(0.07%)were HIV positive,and there was no statistical difference compare with the control group(P>0.05);1 091 cases were TP positive(1.80%),7 607 cases were positive for HBV(12.56%),and 1 062 cases were HCV positive(1.75%),and there were statistically significant differences compared with the control group(P<0.05).In addition,there were 8 cases of HIV and TP double infection,10 cases of HIV and HBV double infection,4 cases of HIV and HCV double infection;3 cases of HIV,TP and HBV triple infection,4 cases of HIV,TP and HCV triple infection,1 case of HIV and HBV,HCV triple infection in the study group;and compared with the control group,it showed an increasing trend(P<0.05).Conclusion The status of transfusion-related infectious diseases in Hubei Province and surrounding areas is still severe.Some patients have been infected with HIV,TP,HBV or HCV before hospitalization,and a few have even had double or triple infection.Clinic should further strengthen the prevention and control of transfusion-related infectious diseases,especially for HIV and TP,and reduce the spread of transfusion-related infectious diseases in the general population.
引文
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[14]梁友宝,常滋毓,王清云等.19 483例患者输血前和术前四项传染性指标检测结果分析[J].淮海医药,2014,32(5):487-487.
[15]陈姗,欧阳春,李丽娟等.15 959例术前及输血前患者感染性指标检测结果分析[J].临床输血与检验,2016,18(6):562-564.
[16]孙海泉,肖革新,郭莹等.中国2008-2012年丙肝流行规律及空间聚集性分析[J].中国公共卫生,2014,30(3):286-289.
[17]BRUNO R,SACCHI P,PUOTI M,et al.Pathogenesis of liver damage in HCV-HIV patients[J].AIDS Rev,2008,10(1):15-24.
[2]ZHANG F,ZHU H,WU Y,et al.HIV,hepatitis B virus,and hepatitis C virus co-infection in patients in the China National Free Antiretroviral Treatment Program,2010-12:a retrospective observational cohort study[J].Lancet Infect Dis,2014,14(11):1065-1072.
[3]余忠清,胡丽华,刘峰.受血者受血前HIV、HBV、HCV及梅毒重叠感染的研究[J].中华医院感染学杂志,2004,14(11):1242-1243.
[4]于兰,桂秀枝,蒙秀宁.194例HIV阳性孕妇HBV HCV及梅毒合并感染状况分析[J].中国艾滋病性病,2011,17(3):308-310.
[5]LU F,JIA Y,SUN X,et al.Prevalence of HIV infection and predictors for syphilis infection among female sex workers in southern China[J].Southeast Asian J Trop Med Public Health,2009,40(2):263-372.
[6]HO D D.Time to hit HIV,early and hard[J].New Engl J Med,1995,333(7):450-451.
[7]吴尊友.中国艾滋病防治面临新形势与新挑战[J].中国公共卫生,2011,27(12):1505-1507.
[8]王丽艳,秦倩倩,丁正伟,等.中国艾滋病全国疫情数据分析[J].中国艾滋病性病,2017,23(4):330-333.
[9]张艳辉,鲍宇刚,厉成梅,等.中国15个大城市艾滋病疫情状况分析[J].实用预防医学,2011,18(5):785-788.
[10]薛大奇.我国梅毒防治面临的挑战及对策[J].中国性科学,2012,21(1):15-16.
[11]李凡,刘晶星.医学微生物学[M].北京:人民卫生出版社,2008,210-211.
[12]赵鹏鹏,孙修福,时玉军等.我国梅毒和淋病流行现况及特征分析[J].健康之路,2017,16(04):256.
[13]姜慧芬,陈卓,方任华,姜立民.我国2004-2012年乙型病毒性肝炎疫情分析[J].中国卫生检验杂志,2015,25(3):408-411.
[14]梁友宝,常滋毓,王清云等.19 483例患者输血前和术前四项传染性指标检测结果分析[J].淮海医药,2014,32(5):487-487.
[15]陈姗,欧阳春,李丽娟等.15 959例术前及输血前患者感染性指标检测结果分析[J].临床输血与检验,2016,18(6):562-564.
[16]孙海泉,肖革新,郭莹等.中国2008-2012年丙肝流行规律及空间聚集性分析[J].中国公共卫生,2014,30(3):286-289.
[17]BRUNO R,SACCHI P,PUOTI M,et al.Pathogenesis of liver damage in HCV-HIV patients[J].AIDS Rev,2008,10(1):15-24.