肝炎病毒标志物阴性老年肝功能异常病因及临床特点  

Clinical features and causes of elderly patients with hepatitis-markers-negative liver dysfunction

作　　者：朱明芬[1] 汤正好[1] 余永胜[1] 江红[1] 奚敏[1] 张韡[1] 臧国庆[1] 

机构地区：[1]上海交通大学附属第六人民医院感染科,上海200233

出　　处：《临床肝胆病杂志》2009年第4期261-263,共3页Journal of Clinical Hepatology

摘　　要：目的收集甲~戊型肝炎标志物阴性的老年肝功能异常患者246例,分析其病因及临床特点。方法检测甲~戊型肝炎病毒血清学标志物、EB病毒等非嗜肝病毒抗体、及自身抗体水平,并行腹部B超或CT等影像学检查。对照组分别为甲~戊型老年病毒性肝炎177例、肝炎标志物阴性青中年肝功能异常40例。统计分析采用卡方检验、t检验。结果肝炎标志物阴性老年肝功能异常发生率高,达58.26%。其中位居前4位的病因依次为：病因不明者27.64%,胆源性肝损21.54%,自身免疫紊乱伴肝损20.33%,EB病毒等非嗜肝病毒感染15.04%,和青中年组相比上述病因构成无差别（P〉0.05）;脂肪肝比例（2.85%）低于青年对照组（P〈0.05）。腹胀、肝掌阳性比例高于老年肝炎组（P〈0.05）,尿黄、纳差比例高于青中年肝炎阴性组（P〈0.05）。临床类型多为急性肝损（81.71%）,慢性肝损、肝衰竭、肝硬化发生率低于老年病毒性肝炎组（P〈0.05）,但和青中年组无明显差异（P〉0.05）。结论老年肝功能异常由非病毒性肝炎引起者所占比例较高;临床表现、疾病严重程度比老年病毒性肝炎组轻。Objective To analyze the causes and clinical features of 246 cases elderly patients with hepatitis A - E markers negative liver dysfunction. Methods To detect hepatitis A - E virus serum markers, Epstein - Barr virus antibodies herpes simplex virus antibodies, cytomegalovirus antibodies coxsackie virus antibodies and autoantibodies. To take abdomen B ultrasound or computerized tomography （CT） examination. There were two control groups, one was 177 cases of elderly patients with hepatitis A - E, and the other was 40 cases of middle - aged patients with hepatitis A - E markers negative liver dysfunction. Chi - square test and t test were used to tatistical analysis. Results Among elderly patients with liver dysfunction, 58.26% were hepatitis A - E markers negative. The top four cases were ： 27. 64% were of unknown causes, 21.54% were caused by biliary diseases, 20. 33% were caused by autoimmune disorders, and 15.04% were EB virus - infected. The proportion of fatty liver （2. 85% ） was lower than middle - aged groups （ P 〈 0. 05 ）. The elderly patients with hepatitis negative liver dysfunction had higher incidence of thick urine and poor appetites than that of middle - aged patients （P 〈 0. 05 ）. As for clinical types, 81.71% exhibited acute liver damage and the incidence of chronic liver damage, liver failure, cirrhosis was less than that of elderly patients with hepatitis A - E （ P 〈 0.05 ）. Conclusion The incidence of hepatitis - markers - negative liver dysfunction in elderly patients were high. The clinical of manifestations and diseases severity were lighter than that of middle - aged patients and elderly patients with hepatitis.

关 键 词：肝功能异常 老年人 病因 临床特征 

分 类 号：R446.1[医药卫生—诊断学]