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目的 了解我国人群丙型肝炎病毒 (HCV)感染的自然演变规律。方法 2 0 0 1- 12～ 2 0 0 2 - 0 7对河北省固安县和赵县 2 83例因单采血浆而感染丙型肝炎者进行调查分析 ,男性 137例 ,女性 14 6例。行腹部超声检查及丙氨酸氨基转移酶 (ALT)、天冬氨酸氨基转移酶 (AST)、谷氨酰转肽酶 (GGT)采用速率法检测 ,HCVRNA的测定采用荧光定量PCR方法。转化生长因子 - β1(TGF - β1)、组织金属蛋白酶抑制因子 - 1(TIMP - 1)、三型前胶原肽(PⅢP)、四型胶原 (PC -Ⅳ )、透明质酸 (HA) ,采用ELISA方法。结果 (1)非侵入性诊断 (包括临床诊断、超声诊断、血清学诊断 )为慢性肝炎轻度者 14 6例 ,占 5 1 .6 % ;中度 97例 ,占 34. 3% ;重度 15例 ,占 5 . 3% ;肝硬化 4例 ,占1 .4 % ;脂肪肝 2 1例 ,占 7 .4 %。(2 ) 2 83例感染者中 2 5 8例测定了HCVRNA ,阴性率 2 3. 3% ,表明该组人群感染HCV后 12～ 2 5年有较高的HCV自发阴转率。 (3)慢性肝炎重度和肝硬化组的ALT、AST、GGT均值明显高于其他组 ,慢性肝炎重度组ALT值异常率为 5 3 .3% (8/ 15 ) ,AST值异常率为 5 3 .3% (8/ 15 )。肝硬化组ALT值异常率为10. 0 % (4/ 4 ) ,AST值异常率为 10. 0 % (4/ 4 ) ,差异有显著性。 (4)慢性肝炎重度和肝硬化组肝纤维化血清学诊断指
Objective To understand the natural evolution of hepatitis C virus (HCV) in Chinese population. METHODS: Two hundred and seventy-three hepatitis C patients infected by apheresis plasma in Gu’an and Zhao counties of Hebei Province were investigated and analyzed. There were 137 males and 146 females. Abdominal ultrasound and alanine aminotransferase (ALT), aspartate aminotransferase (AST) and glutamyl transpeptidase (GGT) were detected by the rate method. The HCV RNA was determined by fluorescence quantitative PCR. The expressions of TGF - β1, TIMP - 1, P Ⅲ P, PC - Ⅳ, and HA were measured by immunohistochemistry. ELISA method. Results (1) Noninvasive diagnosis (including clinical diagnosis, ultrasonic diagnosis and serological diagnosis) was mild in 14.6 cases of chronic hepatitis, accounting for 51.6%; moderate in 97 cases, accounting for 34.3%; severe 15 Cases, accounting for 5.3%; cirrhosis in 4 cases, accounting for 1.4%; fatty liver in 21 cases, accounting for 7.4%. (2) HCV RNA was detected in 258 of 2 83 infected persons, with a negative rate of 23.3%, indicating a high spontaneous HCV spontaneous conversion rate of 12 to 25 years after HCV infection in this group. (3) The average of ALT, AST and GGT in severe hepatitis and chronic liver cirrhosis group were significantly higher than those in other groups. The abnormal ALT value in chronic severe hepatitis group was 53.3% (8/15) and the abnormal AST rate was 5 3 .3% (8/15). The abnormal ALT value of cirrhosis group was 10.0% (4/4), and the abnormality of AST value was 10.0% (4/4), the difference was significant. (4) Serological diagnosis of liver fibrosis in patients with severe chronic hepatitis and cirrhosis