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目的调查北京铁路局天津铁路辖区内铁路系统从业人员戊型肝炎(戊肝)感染情况,探讨戊肝亚临床感染者血清中戊肝病毒(HEV)抗体和丙氨酸氨基转移酶(ALT)及粪便中HEV RNA的动态变化。方法选取2011—2013年在北京铁路局天津铁路疾病预防控制所进行预防性健康检查的从业人员抗HEV-Ig M阳性者共54人,并选取54名抗HEV-Ig M阴性者做对照,检测其血清中ALT和抗HEV-Ig G,计算其异常率和阳性率。对抗HEV-Ig M阳性者进行随访,观察其血清中ALT、抗HEV-Ig M、抗HEV-Ig G及粪便中HEV RNA不同时间的变化情况。结果抗HEV-Ig M阳性组血清中ALT水平、ALT异常率和抗HEV-Ig G阳性率与抗HEV-Ig M阴性组相比,差异无统计学意义(P>0.05)。抗HEV-Ig M阳性人群血清中抗HEV-Ig M和Ig G阳性率在初次检查后90 d内有显著性差异,此时粪便中可以检测到HEV RNA。结论辖区内HEV感染呈亚临床感染状态存在,初次检查后90 d内抗HEV-Ig M和Ig G及粪便中HEV RNA阳性率变化最明显。
Objective To investigate the prevalence of hepatitis E (E) infection in railway system practitioners in Beijing railway bureau under the jurisdiction of Tianjin railway and to explore the relationship between hepatitis E virus (HEV) antibody and alanine aminotransferase (ALT) Dynamic changes of HEV RNA in feces. Methods A total of 54 anti-HEV-Ig M-positive patients were selected for preventive health examination conducted by Tianjin Railway Disease Prevention and Control Institute of Beijing Railway Administration from 2011 to 2013. Fifty-four anti-HEV-Ig M negative patients were selected as controls and tested The serum ALT and anti-HEV-Ig G, calculate the abnormal rate and positive rate. The HEV-Ig M positive patients were followed up, and the changes of serum ALT, anti-HEV-Ig M, anti-HEV-Ig G and HEV RNA in the feces were observed. Results There was no significant difference in serum levels of ALT, ALT abnormalities and anti-HEV-Ig G in anti-HEV-Ig M positive group as compared with those in HEV-Ig M negative group (P> 0.05). The positive rates of anti-HEV-Ig M and Ig G in sera of HEV-Ig M-positive sera were significantly different within 90 days after the initial examination, at which time HEV RNA could be detected in the stool. Conclusion HEV infection in the area is sub-clinically infected. The positive rate of HEV RNA in HEV-Ig M, Ig G and stool samples within 90 days after initial examination is the most obvious.