散发性戊型肝炎156例临床分析  

Clinical features of patients with sporadic hepatitis E:an analysis of 156 cases

作　　者：张勋[1] 孙秋林[1] 李家斌[1] Zhang Xun Sun Qiulin LiJiabin.(Department of Infectious Diseases, First Afflicated Hospital, Anhui Medical University, Hefei 230022, AnhuiProvince, Chin)

机构地区：[1]安徽医科大学第一附属医院感染病科,合肥市230022

出　　处：《实用肝脏病杂志》2017年第6期705-708,共4页Journal of Practical Hepatology

摘　　要：目的探讨散发性戊型肝炎(HE)的临床特点,为临床诊治提供参考。方法 2012年1月~2015年12月我院收治的156例HE患者,回顾性分析其流行病学、临床资料及其预后情况,采用ELISA法检测血清抗-HEV Ig M和抗HEV-Ig G。结果 156例患者发病年龄为(52.9±12.7)岁,男性129例,女性27例,男女比例为4.8:1;各季度均有发病,发病高峰为1~5月,尤以2月份高发,占20.5%;HE重叠慢性乙型肝炎患者血清TBIL水平为(180.8±111.1)μmol/L,和住院时间(23.1±12.2)d,显著高于或长于HE组的(148.6±89.9)μmol/L和(16.7±8.8)d(P<0.05),两组肝衰竭发生率分别为(10.0%和3.8%,P<0.05);≥60岁患者血清TBIL水平和住院时间分别为(194.6±121.4)μmol/L和(22.1±7.0)d,显著高于或长于18~59岁年龄组的(144.1±104.9)μmol/L和(16.9±8.8)d(P<0.05),两组肝衰竭发生率分别为(10.5%和4.0%,P<0.05)。结论 HE患者以中老年男性多见,春季多发,老年及慢性肝病重叠感染者黄疸深,肝衰竭发生率高,病程时间长,需引起临床医生的重视,但总体预后良好。Objective To analyze the clinical features of patients with sporadic hepatitis E(HE).Methods The clinical data of 156 patients with HE were collected in our department between January 2012 and December 2015, and the epidemiologic,clinical features and prognosis were retrospectively analyzed. Serum anti-HEV-Ig M and-Ig G were detected by ELISA. R esults The average age of the 156 patients was 52.9 ±12.7 years old,129 cases were male and 27 were female,and the male and female ratio was 4.8:1;the disease occurred in every quarter,mainly occurred from January to May,especially in February(accounting for 20.5%);serum bilirubin levels and the hospitalization stay in patients with HE with underlying chronic hepatitis B were(180.8 ±111.1)μmol/L and(23.1 ±12.2) days,significantly higher or longer than(148.6±89.9) μmol/L and(16.7±8.8) days in patients with HE(P<0.05),and the incidence of hepatic failure in the two groups were(3.8% and 10.0%,P <0.05);serum bilirubin levels and the hospitalization stay in patients older than 60 years were(194.6±121.4) μmol/L and(22.1±7.0) days,significantly higher or longer than(144.1±104.9) μ mol/L and(16.9±8.8) days in patients18 to 59 years old(P<0.05),and the incidence of hepatic failure in the two groups were(10.5% and 4.0%,P<0.05). Conclusion HE is more common in middle-aged men,and the incidence of sporadic HE varies from January to March. More attention should be taken to elderly patients with HE,especially in patients with underlying chronic liver disease,as they often have a relatively long hospital stays,high serum bilirubin levels and a high incidence of hepatic failure, and the overall prognosis of patients with HE is good.

关 键 词：戊型肝炎 散发 重叠感染 临床特征 

分 类 号：R512.6[医药卫生—内科学]