重型肝炎患者血浆置换后SEN病毒感染及临床意义

摘要

目的 了解重型肝炎患者血浆置换前、后SEN病毒(SENV)感染情况及对肝功能的影响.方法 采用套式PCR对40例重型肝炎患者血浆置换前、后血清中SENVD亚型和H亚型进行检测,并检测血浆置换前、后血液生化改变,数据行t检验和配对X2检验.结果 40例重型肝炎患者血浆置换前、后SENV D亚型的检出率分别为27.5%(11/40)和42.5%(17/40),SENVH亚型为27.5%(11/40)和50.0%(20/40),差异均有统计学意义(X24.17,X27.11;均P<0.05).血浆置换后,SENV阳性患者的ALT为(164±75)U/L,明显高于阴性患者的(48±12)U/L,差异有统计学意义(t=3.13,P<0.05);但肝功能其他各项指标比较,差异无统计学意义.结论 SENV可经血浆置换方式传播,且重叠SENV感染可能会影响重型肝炎患者血浆置换后肝功能的恢复.%Objective To investigate the prevalence of SEN virus(SENV)infection in patients with chronic hepatitis gravis before and after plasma exchange,and its influences on liver function.Methods Two subtypes of SENV,SENV-D and SENV-H were detected in sera from 40 patients with chronic hepatitis gravis before and after plasma exchange.The changes of liver function were also tested before and after plasma exchange.Data analysis was done by t test and ehi-square test.Results Among 40 patients with chronic hepatitis gravis,SENV-D positive rates before and after plasma exchange were 27.5%(11/40)and 42.5%(17/40),respectively,and SENV-H positive rates before and after plasma exchange were 27.5%(11/40)and 50.0%(20/40),respectively,which were all significantly different(X2=4.17,X2=7.11,both P<0.05)between before plasma exchange and after plasma exchange.And after the treatment of plasma exchange,serum alanine aminotransferase(ALT)level was(164±75)U/L in SENV positive patients,which was significantly higher than that in SENV negative patients[(48±12)U/L,t=3.13,P<0.05].But there were no significant differences of other liver function indexes between SENV positive and negative groups.Condusions SENV can be transmitted via plasma exchange.SENV coinfection may influence the restoration of liver function in patients with chronic hepatitis gravia after the treatment of plasma exchange.