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目的了解2型糖尿病肾衰竭患者血液透析HCV感染流行病学特征及危险因素分析,为科学预防透析患者感染HCV提供科学依据。方法收集2004-2014年宁夏人民医院透析中心进行透析的2型糖尿病肾衰竭患者流行病学资料,纳入研究1 926例;酶联免疫吸附试验ELISA检测患者静脉血HCV抗体,Logistic回归分析HCV感染危险因素。结果透析期间HCV感染率为21.13%(407/1 926);2004-2014年感染率呈现下降趋势(χ2趋势=29.26,P=0.001<0.05);2004年透析患者HCV感染率为20.31%,2005年采用肝炎病例与非肝炎病例分区透析后HCV感染率降为10.19%,2008年使用一次性透析器后HCV感染率降为6.35%。回归分析显示,HCV感染的危险因素为血液透析持续时间、透析设备破膜、行透析治疗医院数和输血次数。结论透析机交叉感染和输血是2型糖尿病肾衰竭患者感染丙肝病毒的危险因素,血透室应加强对透析机消毒的管理;对贫血患者使用促红细胞生成素。
Objective To understand the epidemiological characteristics and risk factors of hemodialysis HCV infection in patients with type 2 diabetic renal failure and provide a scientific basis for scientific prevention of HCV infection in dialysis patients. Methods Epidemiological data of patients with type 2 diabetic renal failure who were dialyzed from 2004 to 2014 in Ningxia People’s Hospital were enrolled in this study. A total of 1 926 cases were included in the study. Enzyme-linked immunosorbent assay (ELISA) was used to detect HCV antibodies in patients with venous blood and logistic regression analysis was used to analyze the risk of HCV infection factor. Results The HCV infection rate during dialysis was 21.13% (407/1 926). The infection rate showed a decreasing trend from 2004 to 2014 (χ2 trend = 29.26, P = 0.001 <0.05). The HCV infection rate in dialysis patients in 2004 was 20.31% The HCV infection rate dropped to 10.19% after hemodialysis with year hepatitis and non-hepatitis cases. In 2008, the HCV infection rate dropped to 6.35% after using the disposable dialyzer. Regression analysis showed that the risk factors for HCV infection were the duration of hemodialysis, the rupture of dialysis equipment, the number of hospital dialysis and the number of blood transfusions. Conclusions Dialysis machine cross infection and blood transfusion are risk factors of hepatitis C virus infection in type 2 diabetic patients with renal failure. Hemodialysis should be strengthened to disinfect dialysis machines and erythropoietin should be used in patients with anemia.