HBV/HCV重叠感染患者临床特点分析  

Clinical features and disease outcomes in patients with HBV/HCV superinfection

作　　者：张宁[1,2] 薛红元[1] 赵彩彦[2] Zhang Ning XueHongyuan Zhao Caiyan.(Department of Infectious Disease, Third Hospital, Hebei Medical University,Shijiazhuang050000, Hebei Province, Chin Zhang Ning, Xue Hongyuan. Department of Ultrasound, Hebei General Hospital,Shijiazhuang 050000, Hebei Province, Chin)

机构地区：[1]河北省人民医院超声科,石家庄市050000 [2]河北医科大学第三医院感染病科

出　　处：《实用肝脏病杂志》2017年第6期697-700,共4页Journal of Practical Hepatology

摘　　要：目的由于两种病毒间存在相互干扰,HBV/HCV重叠感染患者临床表现及预后情况与单病毒感染不同。本文旨在探讨HBV/HCV重叠感染患者临床特点及其疾病转归情况,为优化其诊治方案提供依据。方法 2002年11月~2013年12月河北医科大学第三医院住院的HBV/HCV重叠感染患者30例,2013年6月~2014年12月河北医科大学第三医院住院的慢性乙型肝炎(CHB)患者59例,慢性丙型肝炎(CHC)患者54例。对各组患者的临床资料进行回顾性分析。结果 HBV/HCV重叠感染患者血清球蛋白水平为(32.12±6.76)g/L,显著高于CHB组【(28.69±7.16)g/L,P<0.05】,ALT水平为(134.02±209.34)U/L,显著高于CHB组【(71.57±53.23)U/L,P<0.01】,TBIL水平为(62.18±99.05)μmol/L,显著高于CHB组【(30.98±30.70)μmol/L,P<0.01】,GGT水平为(71.60±51.92)U/L,显著高于CHB组【(50.28±47.23)U/L,P<0.05】,PTA水平为(73.39±17.19)%,显著低于CHB组【(91.28±17.71)%,P<0.01】;HBV/HCV重叠感染患者HBe Ag阴性占50.0%,与CHB组的45.0%比,差异无统计学意义(P>0.05);HBV/HCV重叠感染组血清HBV DNA阳性率为50%,显著低于CHB组的79.7%(P<0.01);HBV/HCV重叠感染组血清病毒载量显著低于CHB组,差异有统计学意义(Z=-3.331,P<0.01);HBV/HCV重叠感染组慢性肝炎重度和肝硬化发生率为53.3%,显著高于CHB组的34.0%;重叠感染患者在疾病预后和转归方面与CHB比,差异有统计学意义(Z=-3.121,P<0.01);HBV/HCV重叠感染患者血清白蛋白水平为(37.78±6.74)g/L,显著低于CHC组【(43.07±4.48)g/L,P<0.01】,球蛋白水平显著高于CHC组【(28.83±5.84)g/L,P<0.05】,AST水平为(71.07±48.72)U/L,显著高于CHC组【(51.29±38.61)U/L,P<0.05】,ALT水平显著高于CHC组【(52.91±29.71)U/L,P<0.01】,TBIL水平著高于CHC组【(16.71±7.65)μmol/L,P<0.01】,GGT水平显著高于CHC组【(38.39±29.10)U/L,P<0.01】,PTA水平显著低于CHC组【(104.62±16.10)%,P<0.01】;HBV/HCV重叠感染组与CHC组比,血清病毒载量水平显著低下,差异有统计学意义(Objective Due to the interference between two viruses,the clinical features and prognosis in patients with superinfection of hepatitis B virus and hepatitis C virus(HBV/HCV) are usually different from the patients with single hepatotropic virus infection. The aim of this study is to investigate the characteristics of the mutual interference between the viruses and disease outcomes in patients with HBV/HCV superinfection,and provide evidence to help the diagnosis and treatment for the HBV/HCV superinfection patients. Methods 30 patients with HBV/HCV superinfection were enrolled between November 2002 and December 2013 in the Third Hospital,Hebei Medical University,and 59 patients with chronic hepatitis B(CHB) and 54 patients with chronic hepatitis C(CHC) between June 2013 and December 2014 in the Third Hospital,Hebei Medical University werealso included in this study. All the patients in each group were retrospectively analyzed for the patient's general conditions and clinical data. R esults Serum level of globulin in patients in HBV/HCV superinfection was(32.12±6.76) g/L,significantly higher than that in CHB patients 【(28.69±7.16) g/L, P <0.05】,serum level of ALT was(134.02±209.34) U/L,significantly higher than that in CHB group 【(71.57±53.23)U/L,P<0.01】,serum level of total bilirubin was(62.18±99.05)μmol/L,which was significantly higher than that in CHB group 【(30.98±30.70)μmol/L,P<0.01】,serum level of GGT was(71.60±51.92)U/L,which was significantly higher than that in CHB group【(50.28±47.23)U/L,P<0.05】,and the level of prothrobin time activity(PTA) was(73.39±17.19)%,which was significantly lower than that in CHB group 【(91.28±17.71)%,P<0.01】;the negative rate of serum HBeA g in HBV/HCV superinfection group was 50.0%,not significantly different(P >0.05) as compared to 45.0% in HBV infection group; the positive rate of serum HBV DNA in HBV/HCV superinfection group was 50.0%,which was significantly lower than that in HBV infection group(79.7%,P <0.01);the serum viral load in HBV/HCV

关 键 词：乙型肝炎 丙型肝炎 重叠感染 临床特点 疾病转归 

分 类 号：R512.6[医药卫生—内科学]