再生障碍性贫血合并丙型肝炎的中西医结合临床研究

作者	单位
刘清池	河北省廊坊市血液病研究所
郑博荣	河北省廊坊市血液病研究所
张春丽	河北省廊坊市血液病研究所
刘素平	河北省廊坊市血液病研究所
梁冰	河北省廊坊市血液病研究所

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中文摘要:

我们采用第二代ＥＩＡ法检测了８２例再生障碍性贫血（ＡＡ）患者血清丙型肝炎病毒抗体（抗ＨＣＶ），结果显示，输血治疗的ＡＡ患者抗ＨＣＶ阳性率６９．４％（４３／６２），显著高于未输血患者（ｐ＜０．０１），慢性ＡＡ与急性ＡＡ抗ＨＣＶ阳性率无明显差别（Ｐ＞０．０５）。ＡＡ患者输血后丙型肝炎（ＰＴＨＣ）发生率３３．９％（２１／６２），其中急性ＡＡ６８．８％（１１／１６），慢性ＡＡ２１．７％（１０／４６），前者显著高于后者（Ｐ＜０．０１）。抗ＨＣＶ阳性患者发生ＰＴＨＣ组与未发生ＰＴＨＣ组输血量、血红蛋白水平、白细胞数的差别无统计学意义。抗ＨＣＶ阳性患者ＡＡ有效率明显低于抗ＨＣＶ阴性患者（ｐ＜０．０５）。ＡＡ患者发生ＰＴＨＣ以急性、黄疸型多见，合并ＰＴＨＣ后易出血、感染。本研究结果表明，ＰＴＨＣ已成为ＡＡ的重要合并症，ＡＡ合并ＰＴＨＣ采用中西医结合治疗可取得较好疗效。

英文摘要:

The testing kit of second generation for serum anti-HCV was used in 82 cases of aplastic anemia(AA).The results showed that positive rate was 69.4%(43/62) in the patients of AA with transfusion,this was significantly higher than that in the patients of AA without transfusion.There was no difference of anti-HCV antibody positive rate between chronic AA and acute AA(P>0.05),incidence rate of post-transfusion hepatitis C(PTHC) in AA was 33.9%(21/62),among which the incidence rate in acute and chronic AA were 68.8%(11/16) and 21.7%(10/46) respectively(P<0.01).The anti-HCV positive patients were divided into two groups:PTHC and non-PTHC,there was no statistical difference of their transfusion volume,hemoglobin, white blood cell between these groups.Response rate of AA was lower in anti-HCV positive patients than that in negative patients(P<0.05).Acute,icteric PTHC was predominant in patients with AA.The patients with AA complicated with PTHC was liable to bleed and be infected.PTHC has been an importent complication in patients with AA.The better response was obtained by TCM-WM therapy in the patients.

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