论文部分内容阅读
目的了解丙型肝炎病毒/人类免疫缺陷病毒(HCV/HIV)混合感染患者、单纯HCV感染者的肝脏纤维化发生状况、生化指标改变和生存状况。方法对河南省某村有偿献血感染丙肝和丙肝/艾滋病混合感染患者176例进行肝功能和B超检查;统计三年间死亡发生例数。结合2009年8月第一次随访的资料,进行对比分析。进行KaplanMeier生存分析,得到两种感染类型患者从感染到死亡的中位死亡时间。结果混合感染组肝脏纤维化发生率高于单纯HCV感染组(χ2=11.53,P=0.001)。2012年单纯HCV感染组发生率高于2009年发生率(χ2=22.17,P=0.000),HCV/HIV混合感染组发生率也升高(χ2=4.440,P=0.035)。混合感染组的血清肝功能指标中,GGT、AST、ALT、TBILI、ALB和TP含量比第一次随访时均降低,DBILI升高,GGT水平改变无统计学差异;单纯HCV感染组中ALP、AST、ALT、ALBH和TP均降低,GGT和DBILI水平升高,TBILI水平改变无统计学差异。ALP感染到死亡的中位死亡时间两组不同(χ2=14.74,P=0.001),单纯HCV组感染后至死亡的时间长于混合感染组。结论HIV感染可能是加快单纯HCV感染病人肝脏纤维化和死亡的危险因素。
Objective To investigate the incidence of hepatic fibrosis, biochemical changes and survival in HCV-infected patients with HCV infection. Methods A total of 176 patients with mixed blood donors infected with hepatitis C and C / A in a village of Henan Province were enrolled in the study of liver function and B-ultrasound. The number of deaths in three years was counted. Combined with the first follow-up data in August 2009, a comparative analysis was made. KaplanMeier survival analysis was performed to find the median time to death from infection to infection in both groups. Results The incidence of liver fibrosis in mixed infection group was higher than that in HCV group (χ2 = 11.53, P = 0.001). The incidence of HCV infection in 2012 was higher than that in 2009 (χ2 = 22.17, P = 0.000), and the incidence of HCV / HIV infection was also increased (χ2 = 4.440, P = 0.035). The levels of serum GGT, AST, ALT, TBILI, ALB and TP in the mixed infection group were lower than those at the first follow-up, while the DBILI was increased and there was no significant difference in the GGT level. In the simple HCV infection group, AST, ALT, ALBH and TP were decreased, GGT and DBILI levels were elevated, but TBILI level had no significant difference. The median time to death from ALP infection was different between the two groups (χ2 = 14.74, P = 0.001). The duration of infection after infection in HCV-only group was longer than that in the mixed infection group. Conclusion HIV infection may be a risk factor for liver fibrosis and death in patients with HCV infection.