慢性肝病对散发性戊型病毒性肝炎临床特征的影响探讨  

Effects of chronic liver disease on the clinical features in patients with sporadic viral hepatitis E

作　　者：王文虎[1] 吴国栋[1] 关世运[1] 熊昌清[1] 王健[1] 

机构地区：[1]荆州市第二人民医院感染科,湖北荆州434000

出　　处：《胃肠病学和肝病学杂志》2007年第5期409-411,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨不同原因的慢性肝病对散发性戊型病毒性肝炎(viral hepatitis E,HE)临床特征的影响。方法选取245例HE患者进行回顾性分析。根据基础肝病的不同将其划分为A组(慢性乙肝重叠感染HEV)67例;B组(慢性血吸虫病重叠感染HEV)51例;C组(慢性酒精性肝病合并感染HEV)49例和D组(随机选取同期单纯HEV感染者)78例。观察各组的总胆红素(TBil)峰值、凝血酶原时间国际标准化比值(Prothrombin Time Intertional Normalized Ratio,PT-INR)峰值、痊愈患者平均住院日、重型肝炎发生率和死亡率。结果A-D组TBil峰值、PT-INR峰值、痊愈患者平均住院日、重型肝炎发生率和死亡率分别为117.43±37.92μmol/L,1.68±0.54,20.85±6.45 d,22.39%和14.93%;76.39±23.67μmol/L,1.03±0.32,13.47±4.98 d,11.76%和7.84%;79.65±24.25μmol/L,1.08±0.35,14.91±5.63 d,10.20%和6.12%及68.57±21.34μmol/L,0.99±0.31,12.56±4.21 d,10.26%和3.85%。上述5个指标在A组与D组间比较差异均有显著性(P<0.05);而在B组与D组间、C组与D组间比较差异均无显著性(P>0.05)。结论慢性乙肝患者重叠感染HEV后肝病明显加重,易导致重型肝炎的发生,死亡率高。而慢性血吸虫病,慢性酒精性肝病患者重叠或合并感染HEV后,肝病无明显加重,重型肝炎发生率相对较少,预后尚好。Objective To investigate the effects of different kinds of chronic liver disease on the clinical features in patients with sporadic Viral Hepatitis E （HE）. Methods Two hundred and forty five patients with hepatitis E were selected and reviewed retrospectively. According to the different kinds of underlying liver disease, the patients were divided into following groups： group A （chronic hepatitis B superinfected with HEV, n = 67） , group B （chronic schistosomiasis superinfected with HEV, n = 51 ）, group C （chronic alcoholic liver disease coexisted with HEV, n = 49）, and group D （the patients infected with HEV alone were randomized as control during the corresponding period, n = 78）. The peak value of total bilirubin （TBil） and PT-INR, average days stayed in hospital, morbility of fulminant hepatitis and mortality of patients in above all groups was observed. Results The values of above five indexes in group A,B, C and D were （117.43±37.92） μmol/L, 1.68±0.54, （20.85±6.45）d, 22.39% and 14.93%; （76.39±23.67） μmol/L, 1.03 ±0.32, （13.47 ±4.98） d, 11.76% and 7.84%; （79.65 ±24.25） μmol/L, 1.08 ±0.35, （14.91 ± 5.63） d, 10.20% and 6. 12% ; （68.57 ±21.34） μmol/L, 0.99 ±0. 31, （12.56 ±4.21） d, 10. 26% and 3.85% respectively. There were significant statistical differences in above five indexes between group A and D（P 〈 0. 05） , but no significant differences between group B and D （ P 〉 0.05 ） , and between group C and D （P 〉 0.05 ） either. Conclusions More severe hepatic damage would be observed in the patients with chronic hepatitis B after being superinfected with HEV. Morbility of fulminant hepatitis and the mortality of the patients would obviously increase.

关 键 词：戊型病毒性肝炎 重叠感染 临床特征 

分 类 号：R575[医药卫生—消化系统]