五型病毒性肝炎的暴露因素与临床表现的比较  

The comparison of exposure factors and clinical presentation in five types of viral hepatitis

作　　者：董菁[1,2] 张景霞[1,2] 阎永平[1,2] 徐德忠[1,2] 李远贵[1,2] 陈友绩[1,2] 朱晓洁[1,2] 庄辉[1,2] 

机构地区：[1]第四军医大学流行病学教研室 [2]北京医科大学肝炎研究中心

出　　处：《第四军医大学学报》1996年第3期181-184,共4页Journal of the Fourth Military Medical University

摘　　要：目的：比较急性病毒性肝炎患者感染的可能危险因素，同时比较五型肝炎的症状和体征．方法：连续收集住院急性病毒性肝炎患者血清２９３份，用ＥＬＩＳＡ法检测了五型肝炎病毒的病原学指标，并进行了流行病学调查．结果：暴露因素：丙肝的肠道外暴露史明显多于甲肝（Ｐ＜０．０５）；甲肝和戊肝有较高的“甲肝”患者接触史；乙肝、丙肝和丁肝有高的“乙肝”接触史，与甲肝、戊肝相比差异显著（Ｐ＜０．０１）．散发性戊肝无明显的生水饮用史．临床症状：乏力、厌食、尿黄和恶心为病毒性肝炎发病的四大主症，甲肝发热与呕吐的发生率较乙肝、丙肝为高（Ｐ均＜０．０５）．体征：丙肝和丁肝的脾肿大检出率较甲肝（均Ｐ＜０．０５）和戊肝为高（Ｐ＜０．０１）．结论：急性丙肝患者发病前有高的医源性血液接触史．以症状和体征分析，甲肝与戊肝表现相近，而乙肝。Objective: To compare exposure factors, symptoms and signs of five types of acute viral hepatitis. Methods: We have consecutively collected 293 blood samples and epidemiological data from the hospitalized patients who were clinically diagnosed with acute viral hepatitis in four hospitals of Xi'an. The viral markers of five types were detected by ELISA kits. Results: Comparing with hepatitis A (HA), hepatitis C (HC) had higher parenteral exposure rate, with statistically significant difference ( P <0.05). The HA or hepatitis E (HE) had higher rate of contact with the “HA” in the last 6 months. Similarly, the hepatitis B (HB), HC and hepatitis D (HD) had higher rate of contacting with “HB”, comparing with HA or HE, the difference was significant ( P <0.01). There was no difference in enteral exposure history. The HE had no significant drinking unboiled water history. Weakness, disgusting to food, yellow urine and vomiting were the four main symptoms of viral hepatitis. There was no difference in the five types viral hepatitis in these symptoms. But the HA had a higher rate of fever and vomiting presentation than HB and HC (both P <0.05). There was a higher rate of splenomegaly in HC and HD than HA (both P <0.05) and HE (both P <0.01). Conclusion: There was a higher rate of iatrogenic blood contact history in acute HC group. The HA and HE are similar in symptoms and signs, so are the HB, HC and HD.

关 键 词：病毒性肝炎 暴露因素 症状 体征 流行病学 

分 类 号：R512.601[医药卫生—内科学]