1489例散发性戊型肝炎患者临床分析  

Clinical analysis of 1489 cases of sporadic acute hepatitis E in Beijing,China

作　　者：朱冰[1] 游绍莉[1] 刘鸿凌[1] 荣义辉[1] 李晨[1] 臧红[1] 万志红[1] 辛绍杰[1] 

机构地区：[1]解放军第三〇二医院,北京100039

出　　处：《中国病毒病杂志》2015年第3期208-211,共4页Chinese Journal of Viral Diseases

基　　金：全军医学科技青年培育项目(13QNP189)

摘　　要：目的总结分析大宗散发性急性戊型病毒性肝炎(hepatitis E)的临床特点,为散发性戊型肝炎的防治提供依据。方法收集解放军第三〇二医院2003-2012年所有急性戊型病毒性肝炎的临床资料,对患者临床分型、转归等采用SPSS 21.0统计软件进行统计分析,计量资料以均数±标准差(x±s)表示,组间均数比较符合正态分布、方差齐性者用t检验和方差分析;不符合正态分布、方差齐性者用秩和检验。P<0.05为差异有统计学意义。结果 2003-2012年解放军第三〇二医院共收治急性戊型肝炎患者1 489例,主要来自华北地区,以冬春季节多发,常见于青中年患者,占急性戊型肝炎患者总数的73.81%。急性黄疸型(总胆红素值≥17.1μmol/L)1 376例,占92.41%,急性无黄疸型113例,占7.59%。普通型戊型肝炎患者最多,占78.64%(1 171/1 489);淤胆型戊型肝炎患者186例,占12.49%;戊型肝衰竭患者132例,占8.87%。治疗好转率在普通肝炎组、淤胆型肝炎组、肝衰竭组分别为97.78%(1 145/1 171)、97.31%(181/186)、39.39%(52/132),肝衰竭组明显比其他两组转归差(P<0.05),同时重叠感染在肝衰竭组占50.00%,与其他两组之间比较差异均有统计学意义(P<0.05)。老年戊型肝炎患者(年龄≥60岁)376例(25.25%),青少年戊型肝炎(年龄<18岁)14例(0.94%)。老年治愈好转率92.29%;青少年治愈好转率100.00%。结论散发性戊型肝炎一般预后较好,但是发展为肝衰竭者预后较差,年龄大、重叠感染、肝硬化基础是病情危重的危险因素。Objective To analyze the clinical characteristics of patients with sporadic acute hepatitis E in Beijing,China. Methods The clinical characteristics of all sporadic acute hepatitis E patients were collected in the 302 th Military Hospital in Beijing of China from 2003 to 2012,and the clinical classifications and outcomes of those patients were analyzed. Results A total of 1 489 cases of all sporadic acute hepatitis E patients were enrolled from 2003 to 2012in this study,patients were mainly from Northern China,most in winter and spring.Sporadic acute hepatitis E is common in young and middle-age patients that accounted for 73.81% of the total patients.Out of all cases,1 376（92.41%）were acute icteric hepatitis patients（total bilirubin were greater than or equal to 17.1μmol/L）,113（7.59%）were acute anicteric hepatitis.Ordinary type of acute hepatitis E was the most common type（78.64%）.Cholestasis type of acute hepatitis E was the secondly common type（12.49%）.Hepatitis E virus-related liver failure was 8.87%.The improvement rates in ordinary type group,Cholestasis type group and liver failure group were 97.78%,97.31% and 39.39% respectively.The outcomes of liver failure group were poorer than that of the other two groups（P〈0.05）.Fifty percent superinfection occurred in the liver failure group and it is significantly higher that of other two groups（P〈0.05）.Elderly patients with acute hepatitis E were 376cases（25.25%）while adolescent patients only 0.94%.The cure and improvement rates in elderly patients with acute hepatitis E and adolescent patients with acute hepatitis E were 92.29%and 100.00%,respectively. Conclusions Sporadic acute hepatitis E patients usually have a good prognosis,but the hepatitis E virus-related liver failure patients had a poor prognosis.Old age,superinfection and the basis of cirrhosis were risk factors in sporadic acute hepatitis E patients.

关 键 词：戊型肝炎 临床特征 肝衰竭 

分 类 号：R512.6[医药卫生—内科学]