湖北省散发性戊型病毒性肝炎167例临床分析  

Clinical features of 167 patients with sporadic viral hepatitis E in Hubei province

作　　者：王文虎[1] 王鲁文 龚作炯[2] 

机构地区：[1]武汉大学第一临床学院 [2]武汉大学人民医院感染科

出　　处：《公共卫生与预防医学》2007年第2期24-26,共3页Journal of Public Health and Preventive Medicine

摘　　要：目的探讨湖北省散发性戊型病毒性肝炎(hepatitis E,HE)的临床特征。方法选取167例HE患者进行回顾性分析,并将患者划分为:1组(单纯HEV感染,61例),2组(慢性乙肝重叠感染HEV,49例),3组(慢性血吸虫病重叠感染HEV,45例)和4组(其他重叠感染及合并症类型,12例);另外根据患者年龄将其分为老年组(年龄≥60岁,72例)和非老年组(年龄<60岁,95例)。对患者的总胆红素(TBil)峰值、平均住院日、重肝发生率和死亡率进行统计学分析。结果上述4个指标在3组和1组间比较差异均无显著性(P>0.05);在2组和1组间比较差异均有显著性(P<0.05);在老年组和非老年组间比较差异均有显著性(P<0.05)。结论慢性乙肝患者重叠感染HEV后肝病明显加重,重型肝炎的发生率高,死亡率高。慢性血吸虫病患者重叠感染HEV后,重型肝炎发生率低,愈后尚好。老年戊肝患者易导致重型肝炎的发生,死亡率高。Objective To analyze the clinical features in the patients with sporadic Hepatitis E in Hubei province. Methods 167 patients with hepatitis E were reviewed retrospectively. The patients were divided into following groups： group 1 （ infected simply by HEV, n = 61 ）, group 2 （ chronic hepatitis B superinfected with HEV, n = 49）, group 3 （ chronic schistosomiasis superinfected with HEV, n = 45 ） and group 4 （ other chronic diseases superinfected with HEV, n =12）. In addition, the patients were also divided into two groups： the elderly group （age ≥60 years, n =72） and the control group （age 〈60 years, n =95）. The peak value of serum total bilirubin （TBil）, average days of hospitalization, morbidity of fulminant hepatitis and mortality of patients were analyzed. Results There were significant statistical differences among the above four indexes between group 2 and 1 （ P 〈 0.05） , however, there were no significant differences between group 3 and 1 （P 〉 0. 05）. There were also significant statistical differences among the above four indexes between the elderly group and the control group （ P 〈 0.05 ）. Conclusion It is suggested that the condition of the patients with chronic hepatitis B would be aggravated after their superinfection by HEV. However, the liver damage of the patients with chronic schistosomiasis would not become more severe after their superinfection by HEV, the morbidity of severe hepatitis was low, and the prognosis was good. It is also indicated that the elderly patients （age ≥60 years） with hepatitis E would be prone to suffer severe liver damage and the morbidity was high.

关 键 词：戊型病毒性肝炎 重叠感染 年龄 临床特征 

分 类 号：R512.6[医药卫生—内科学]