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目的分析有偿献血人群血浆雌二醇(estradiol,E2)水平与丙型肝炎病毒(hepatitis C virus,HCV)感染情况及肝功能指标的关系,为HCV感染转归的致病机理及其预防提供参考依据。方法以江苏省某县级市于1990年前后曾发生有偿献血行为的男性和大于50岁以上的女性为研究对象,共收集样本195例,其中健康对照组56例,自限清除组44例和持续感染组95例。通过检测3组人群的E2和肝功能指标包括丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、总胆红素(total bilirubin,Tbil)、直接胆红素(direct bilirubin,Dbil)、谷酰转肽酶(gamma-glu-tamyl transpeptidase,GGT)、碱性磷酸酶(alkaline phosphatase,ALP)的浓度,分析它们与HCV感染转归及相互之间的关系。结果以献全血次数、单采血浆次数和脂肪肝和/或肝硬化为协变量,3组间的ALT(P=0.003)和AST(P=0.025)水平差异均有统计学意义;E2与ALT、AST、GGT和ALP呈弱的负相关,但差异均无统计学意义(均有P>0.05)。多因素Logistic回归分析结果显示,年龄增长是慢性HCV感染者血清ALT升高的独立危险因素(OR=1.122,95%CI:1.036～1.215)。结论为预防HCV感染的发生,应加强并规范采供血的管理,而连续的大样本的随访研究有助于进一步探讨血浆E2水平对HCV感染转归及肝功能的影响作用。
Objective To analyze the relationship between the level of estradiol (E2) and the infection of hepatitis C virus (HCV) in patients with compensated blood donation and the indexes of liver function, and to provide reference for the pathogenesis and prevention of the prognosis of HCV infection in accordance with. Methods A total of 195 samples were collected from men and women over 50 years of age who had paid blood donations before and after 1990 in a county-level city of Jiangsu Province. Among them, 56 were healthy controls and 44 were self-limited Continuous infection in 95 cases. The indexes of E2 and liver function in the three groups of people were detected, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (Tbil) Direct bilirubin (Dbil), gamma-glu-tamyl transpeptidase (GGT) and alkaline phosphatase (ALP) were detected and analyzed for their relationship with HCV infection Relationship between. Results There were significant differences in the ALT (P = 0.003) and AST (P = 0.025) levels between the three groups in terms of the number of whole blood donations, the number of apheresis and fatty liver and / or cirrhosis. E2 and ALT, AST, GGT and ALP were weakly negative correlation, but the difference was not statistically significant (both P> 0.05). Multivariate Logistic regression analysis showed that age was an independent risk factor for elevated serum ALT in patients with chronic HCV infection (OR = 1.122, 95% CI: 1.036-1.215). Conclusion In order to prevent the occurrence of HCV infection, we should strengthen and standardize the management of blood supply and follow-up, and follow-up study of large continuous samples will help to further explore the effect of plasma E2 on the outcome of HCV infection and liver function.