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目的了解丙型肝炎病毒(HCV)感染后持续活动者的临床转归和肝脏组织学情况。方法5例因输血而感染丙型肝炎者,为女性,4例因单采血浆还输血球而感染丙型肝炎者,为男性,总共9例,所有感染者感染时间、感染途径清楚。采用炎症分级纤维化分期以及修正的Knodell评分对肝脏活检组织的炎症和纤维化程度进行评价,超声检查,血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)采用速率法,抗HCV采用酶联免疫吸附试验(ELISA)方法,HCVRNA定性检测采用RocheCobasHCV聚合酶链反应(PCR)试剂盒,HCVRNA定量采用BayerHCV分枝DNA(bDNA)试剂盒,HCVRNA基因型采用BayerLiPA基因型分析方法。结果(1)9例慢性丙型肝炎感染者共随访13～14年,其间于诊断时、1992、1995、1999、2003、2004年共检测6次ALT水平,均高于正常上限值(ULN)。(2)2004年检测9例慢性丙型肝炎感染者HCVRNA定性均为阳性,定量从3.57×108拷贝/L～7.21×109拷贝/L,大于2.00×109拷贝/L者5例。3例感染者为基因2型,其余6例为基因1b型。(3)9例慢性丙型肝炎感染者超声诊断为慢性炎症轻度者3例(3/9),占33.3%;中度6例(6/9),占66.7%;重度0例;脂肪肝1例(1/9),占11.1%。未发现失代偿性肝硬化和原发性肝癌。(4)9例慢性丙型肝炎感染者的肝组织炎症活动度(HAI)分数为5～8.5分,纤维
Objective To investigate the clinical outcomes and liver histology of persistent active patients after hepatitis C virus (HCV) infection. Methods Five patients who were infected with hepatitis C due to blood transfusion were female. Four patients were infected by apheresis with blood transfusion and were infected with hepatitis C, and they were male. A total of 9 patients were infected with all the infected patients and the infection route was clear. The degree of inflammation and fibrosis in liver biopsy tissues were evaluated by grading of inflammatory staging fibrosis and modified Knodell score. Ultrasonography, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) ELISA and ELISA were used to detect the HCV RNA. The RocheCobas HCV polymerase chain reaction (PCR) kit was used for the qualitative detection of HCV RNA. The Bayer HCV virulent DNA (bDNA) kit was used for HCV RNA quantification. The BayerLiPA genotype Analytical method. Results (1) Nine patients with chronic hepatitis C were followed up for 13 to 14 years. During the diagnosis, 6 ALT levels were detected in 1992, 1995, 1999, 2003 and 2004, all of which were higher than the upper limit of normal (ULN ). (2) HCV RNA was positive in 9 cases of chronic hepatitis C infection detected in 2004, and the quantification was from 3.57 × 108 copies / L to 7.21 × 109 copies / L, more than 2.00 × 109 copies / L in 5 cases. 3 cases were infected with genotype 2, the remaining 6 cases of genotype 1b. (3) Among the 9 cases of chronic hepatitis C infection, 3 cases (3/9) were diagnosed as mild chronic inflammatory disease by ultrasound, accounting for 33.3%; 6 cases (6/9) were moderate, accounting for 66.7%; 0 cases were severe; Liver 1 case (1/9), accounting for 11.1%. No decompensated cirrhosis and primary liver cancer were found. (4) Hepatic inflammation activity (HAI) score of 9 chronic hepatitis C patients was 5 ~ 8.5,