2型糖尿病患者戊型肝炎病毒感染状况调查  

Seroprevalence and Incidence of Hepatitis E Virus Infection in Patients with Type 2 Diabetes Mellitus

作　　者：程艳冬[1] 黄红玉[2] 陈姗姗[2] 许碧云[2] 毕艳[1] 朱大龙[1] 周乙华[2,3] 

机构地区：[1]南京大学医学院附属鼓楼医院内分泌科,210008 [2]南京大学医学院附属鼓楼医院中心实验室,210008 [3]南京大学医学院附属鼓楼医院感染科,210008

出　　处：《医学研究杂志》2017年第4期36-40,共5页Journal of Medical Research

基　　金：国家自然科学基金资助项目(30872235)

摘　　要：目的调查2型糖尿病患者戊型肝炎病毒(hepatitis E virus,HEV)感染状况,并分析糖尿病合并肝功能异常与HEV感染的关系。方法纳入住院治疗的2型糖尿病患者413例,其中病程小于6个月的新确诊病例78例。采用ELISA法初筛血清抗-HEV IgG和IgM抗体,阳性血清进一步采用Western blot法确认。结果男性230例,女性183例,平均年龄58.3±14.8岁(14~90岁)。抗-HEV IgG阳性145例(35.1%),男性与女性阳性率分别为35.2%和35.0%(P=0.959);抗-HEV IgG阳性率随年龄而升高,至40岁后稳定在35%左右。新确诊与非新确诊糖尿病患者抗-HEV IgG阳性率基本相同(35.9%和34.9%,P=0.871)。各项肝功能指标异常者与正常者的抗-HEV IgG阳性率相似,抗-HEV IgG阳性和阴性两组患者的肝功能异常率基本相同。此外,3例(0.7%)患者抗-HEV IgG和IgM同时阳性,均为非新确诊病例,肝功能正常。结论本组2型糖尿病患者抗-HEV IgG血清流行率为35.1%,近期感染率0.7%,为亚临床感染。本研究结果提示,糖尿病发病与HEV感染无关,抗-HEV IgG阳性对糖尿病患者的肝功能无不良影响。Objective To investigate the status of hepatitis E virus （HEV） infection in patients with type 2 diabetes mellitus and assess the role of HEV infection in the patients with abnormal liver function tests. Methods Serum samples from 413 hospitalized patients with type 2 diabetes mellitus, including 78 newly diagnosed ones, were tested for anti - HEV IgG and IgM by a unique ELISA based on the immunodominant polypeptide and truncated polypeptide. The positive samples were further confirmed by Western blotting. Statistical analysis was done with chi - square test or Fisher＇s exact test. Results Of the 413 patients, 230 were male and 183 were female, with the average age 58.3 ± 14.8 years old （14 -90）. Totally 145 （35.1%） patients were anti - HEV IgG positive. The prevalence had no statistical difference between male and female patients （35.2% vs 35.0% , P = 0. 959）. The prevalence was increased over the age and reached to relative constancy （35%） after 40 years old. The prevalence of anti - HEV IgG in the newly diagnosed patients was comparable with that in the non - newly diagnosed ones （35.9% vs 34.9% , P = 0. 871 ）. The patients with abnormal liver function tests showed similar positive rate of anti - HEV IgG compared with those with normal liver function tests. The patients with positive anti - HEV IgG and negative anti - HEV IgG had similar rates of abnormal liver function tests. Additionally, three non - newly diagnosed patients were positive for both IgM and IgG, with normal liver functions. Conclusion The prevalence of anti - HEV IgG in this group of type 2 diabetes patients was 35.1% and the incidence rate of subclinical infection was 0.7%. The data suggest that the onset of type 2 diabetes is less likely associated with HEV infection, which has minimal long - term influence on the liver functions in the patients with type 2 diabetes patients.

关 键 词：2型糖尿病 肝功能异常 戊型肝炎病毒 IGG抗体 IGM抗体 

分 类 号：R587.1[医药卫生—内分泌] R512.6[医药卫生—内科学]