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目的了解出入境人员丙型肝炎(HCV)感染水平,研究HCV感染者的传染性及影响感染的危险因子。方法采用酶联免疫吸附试验(ELISA)筛查出入境人员抗-HCV,并对150份抗-HCV阳性血清采用实时荧光定量PCR法测定HCV RNA病毒载量,以性别、年龄、抗-HCV阴性、HCV RNA阴性、1∶4比例为匹配条件,选择600例为阴性对照组。采用单因素和多因素非条件Logistic回归分析。结果23781名出入境人员传染病监测体检中,检出抗-HCV阳性150例,检出率为0.63%。男女间感染HCV的几率均等;抗-HCV阳性率随年龄增长而升高,各年龄组间差异有统计学意义(χ2=86.065,P<0.001);外籍人员抗-HCV阳性率显著低于中国籍,两者差异有统计学意义(χ2=12.376,P<0.005);78.67%抗-HCV阳性者HCV RNA病毒处于复制状态,抗-HCV滴度≥1∶64感染者HCV RNA病毒载量均≥1.02×104copy/ml,各抗体滴度间病毒载量有显著性差异(χ2=136.593,P<0.001);经单因素回归分析发现,年龄、国籍、谷丙转氨酶(ALT)、天门冬氨酸转氨酶(AST)、直接胆红素(DBIL)、尿素(BUN)、总胆固醇(CHOL)、低密度脂蛋白(LDL)等8个因子均有统计学意义,对这8个因子进行多因素Logistic逐步回归分析,年龄、ALT、LDL等3个因子进入模型。结论78.67%出入境人员HCV感染者具有传染性,抗-HCV滴度≥1∶64指标可作为HCV具有传染性的判断指标;影响HCV感染的危险因子有年龄、国籍、ALT、AST、DBIL、BUN、CHOL、LDL等8个。
Objective To understand the level of hepatitis C (HCV) infection in entry-exit personnel and to study the contagion and risk factors of infection in HCV-infected persons. Methods Anti-HCV was screened by enzyme-linked immunosorbent assay (ELISA). HCV RNA was detected by real-time fluorescence quantitative PCR in 150 anti-HCV positive sera. Gender, age, anti-HCV negative , HCV RNA negative, 1: 4 ratio for the matching conditions, 600 were selected as the negative control group. Univariate and multivariate non-conditional logistic regression analysis. Results 23781 immigrants out of the country in infectious disease surveillance examination, anti-HCV positive 150 cases were detected, the detection rate was 0.63%. The risk of HCV infection between men and women was equal. The positive rate of anti-HCV increased with age, with significant difference among all age groups (χ2 = 86.065, P <0.001). The anti-HCV positive rate of foreigners was significantly lower than that of China The difference was statistically significant (χ2 = 12.376, P <0.005); HCV RNA viruses were replicative in 78.67% of anti-HCV positive patients, HCV RNA viral load of anti-HCV titer≥1: 64 (Χ2 = 136.593, P <0.001). According to univariate regression analysis, age, nationality, alanine aminotransferase (ALT), aspartate AST, DBIL, BUN, CHOL, LDL and other 8 factors were statistically significant, these 8 factors were multi-factor Logistic regression analysis, age, ALT, LDL and other three factors into the model. Conclusions 78.67% of HCVs infected and exacerbated were transmissible, and the anti-HCV titer≥1:64 could be used as an indicator of HCV infection. The risk factors affecting HCV infection were age, nationality, ALT, AST, DBIL, BUN, CHOL, LDL, etc. 8.