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目的了解天津市和平区二级及以上医疗机构就诊患者丙型肝炎病毒(HCV)感染状况,掌握抗-HCV阳性病例流行特征。方法通过查阅医疗机构门诊日志、病案室登记等相关信息收集资料,对抗-HCV阳性住院病例进行流行病学调查。结果和平区医疗机构2012年抗-HCV血清检测55 903份,阳性率为0.48%,综合医院抗-HCV阳性检出率高于专科医院,二级医院高于三级医院。2013年流行病学调查显示:抗-HCV阳性住院病例中,71.43%为丙型肝炎(简称丙肝)无症状者,70.13%病例为首次发现,肝功能检测ALT异常占32.47%,A/G异常占76.62%。抗-HCV阳性者中有手术史、输血史者比例较高,41~60岁年龄组有输血史者检出率高于其他年龄组。22.08%病例进行治疗,16.89%病例转为慢性或携带者,12.99%转为肝癌、肝硬化,丙肝认知情况通过宣教后知晓率达95%以上。结论抗-HCV阳性在综合性医院检出率较高,虽然抗-HCV阳性者大多无临床症状,但肝功能检测相关生化指标多出现异常,感染因素以手术和输血为主,抗-HCV阳性者转为慢性、肝硬化、肝癌比例较高,大量开展宣教工作可以提高患者对丙肝的认知程度。
Objective To understand the status of Hepatitis C virus (HCV) infection in patients from second-tier and above medical institutions in Heping District, Tianjin, and to find out the epidemiological characteristics of anti-HCV positive cases. Methods The epidemiological investigation was carried out against the positive HCV-in-hospital cases by referring to the information collected from outpatient clinics and registering cases in medical institutions. Results In 2012, 55 903 anti-HCV sera were detected in Heping district medical institutions, the positive rate was 0.48%. The positive rate of anti-HCV positive in general hospitals was higher than that in special hospitals, and that in second-class hospitals was higher than that in third-class hospitals. According to epidemiological survey in 2013, 71.43% of hepatitis C patients were asymptomatic for hepatitis C virus (HCV), 70.13% of them were detected for the first time. ALT abnormalities accounted for 32.47%, A / G abnormalities Accounting for 76.62%. Among the anti-HCV positive patients, there was a history of surgery and a high proportion of blood transfusion history. The detection rate of transfusion history in 41-60 years old group was higher than other age groups. 22.08% cases were treated, 16.89% cases turned to chronic or carriers, 12.99% turned to liver cancer, liver cirrhosis, hepatitis C cognition awareness reached more than 95% after mission. Conclusions The positive rate of anti-HCV in the general hospitals is high. Although most of the anti-HCV positive patients have no clinical symptoms, the biochemical indexes of liver function tests are abnormal. The main infection factors are surgery and blood transfusion, and the anti-HCV positive To chronic, cirrhosis, liver cancer higher proportion of large-scale missionary work can improve the patient’s cognition of hepatitis C.