关键词: 慢性丙型肝炎, 肝纤维化, 有偿献血史, 危险因素

Abstract: Objective To investigate the risk factors of severe hepatic fibrosis in patients with chronic hepatitis C（CHC） with previous paid blood donation. Methods 248 patients with CHC who had paid blood donation history were recruited in this study between January 2015 and December 2017. FIB-4 index was used to diagnose liver fibrosis,and we set the FIB-4 index greater than 3.25 as severe hepatic fibrosis and the FIB-4 index less than 3.25 as non-severe hepatic fibrosis. Univariate analysis of variance（ANOVA） and multivariate Logistic regression analysis were applied to analyze the risk factors of severe hepatic fibrosis in patients with CHC. Results Out of 248 patients with CHC and paid blood donation,86 cases（34.7%） had severe hepatic fibrosis,and 162 cases（65.3%） were non-severe hepatic fibrosis;univariate analysis showed that the ducation,course of disease,month income,concomitant diabetes mellitus,smoking,alcohol consumption and antiviral therapy （interferon-αplus ribavirin≥9 months） between the two groups were significantly different（P<0.05）,while age,gender,concomitant blood hypertension,with hepatitis B viral coinfection were not significantly different（P>0.05）;serum HCV RNA load in patient with severe hepaitc fibrosis was（86250.4±673.7） IU/ml,no significantly different as compared to （86193.1±702.5）IU/ml in patients without severe hepatic fibrosis （P>0.05）,while fasting blood glucose level was （6.8±1.3） mmol/L,serum ALT level was （47.3±10.4）U/L,AST level was（48.1±10.7） U/L,and peripheral white blood cell count was（3.8±1.0）×10⁹/l,significanyly different as compared to[（5.9±1.1） mmol/L,（36.9±9.6） U/L,（35.6±10.1） U/L and（5.0±1.2）×10⁹/l,respectively,P<0.05】 in patients without severe hepatic fibrosis;multivariate Logistic regression analysis showed that concomitant diabetes mellitus（OR=1.982,P=0.002）,alcohol consumption（OR=3.422,P=0.019）,long course of disease（OR=2.648,P=0.006）,month income （OR=2.413,P=0.029）,and without antiviral therapy（OR=4.733,P=0.030） were the independent risk factors for severe hepatic fibrosis in patients with CHC and previous paid blood donation. Conclusion Hepatitis C infection tends to be a chronic process,which might induce liver fibrosis. The individuals with HCV infection could have severe hepatitis fibrosis if they had unhealthy life style, concomitant diseases and couldn’t afford antiviral therapy. The clinicians must pay more attention to them.

Key words: Hepatitis C, Hepatic fibrosis, Paid blood donation, Risk factors