老年戊型肝炎患者临床特征以及血生化和免疫指标特征分析  

Analysis on characteristics of clinical features,blood biochemistry and immune indicators in elderly patients with hepatitis E

作　　者：徐少保 高人焘 徐瑗瑗 Xu Shaobao;Gao Rentao;Xu Yuanyuan(Department of Infectious Diseases,the First Affiliated Hospital,University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]中国科技大学第一附属医院感染病科,合肥230001

出　　处：《中华老年医学杂志》2020年第8期923-926,共4页Chinese Journal of Geriatrics

摘　　要：目的总结老年戊型肝炎患者的临床、血生化以及免疫指标的特征。方法回顾性分析2015年1月至2018年12月我院收治的223例戊型肝炎患者,根据年龄将其分为老年组(年龄≥60岁)与非老年组,比较两组戊型肝炎患者的临床特征、血生化以及免疫指标的差异。结果共有101例老年戊型肝炎患者和122例非老年戊型肝炎患者纳入分析,两组患者年龄分别为(68.9±6.6)岁和(46.2±8.8)岁。两组患者性别、住院时间、是否伴有黄疸、腹水以及腹痛、院内死亡以及其他合并疾病的差异均无统计学意义(均P>0.05);但与非老年组总胆红素56.7(134.8)μmol/L、直接胆红素37.7(110.4)μmol/L、间接胆红素15.2(25.0)μmol/L、谷氨酰转肽酶127.5(176.2)U/L、白蛋白36.9(6.2)g/L比较,老年组患者的胆红素水平更高、谷氨酰转肽酶和白蛋白水平更低。总胆红素140.4(263.8)μmol/L、直接胆红素105.9(199.0)μmol/L、间接胆红素24.7(488.0)μmol/L、谷氨酰转肽酶98.0(113.0)U/L、白蛋白32.2(8.2)g/L(Z=3.289、3.111、2.505、2.117、5.484,P=0.001、0.002、0.012、0.034、0.000),其余血生化指标比较差异均无统计学意义(均P>0.05)。在免疫指标上,与非老年组患者7.9(24.4)比较,老年组患者具有更高的抗戊型肝炎病毒IgM 17.3(53.0)(Z=2.351,P=0.019),而抗戊型肝炎病毒IgG阳性率两组患者比较差异无统计学意义(χ2=1.284,P=0.526)。结论老年戊型肝炎患者的某些血生化与免疫指标显著不同于非老年患者,但临床特征未见不同,临床诊疗过程中应考虑相关指标的变化。Objective To summarize the characteristics of clinical features,blood biochemistry and immune indicators in elderly patients with hepatitis E.Methods A total of 223 patients with hepatitis E were divided into elderly(n=101)versus non-elderly(n=122)groups and the mean age was(68.9±6.6)years and(46.2±8.8)years,respectively.The differences in clinical characteristics,blood biochemistry and immune indicators were compared between the two groups.Results No significant differences in the gender,length of hospital stay and the combinations with jaundice?ascites,abdominal pain,hospital death and other co-morbidities were found between the two groups(P>0.05).But the elderly group versus non-elderly group showed significantly higher levels of total bilirubin[140.4(263.8)μmol/L 56.7(134.8)μmol/L,Z=3.289,P=0.001],direct bilirubin[105.9(199.0)mol/L vs.37.7(110.4)μmol/L,Z=3.Ill,P=0.002]and indirect bilirubin[24.7(488.0)μmol/L vs.15.2(25.0)μmol/L,Z=2.505,P=0.012],and showed significantly lower levels of glutamyl transferase[98.0(113.0)U/L vs.127.5(176.2)U/L,Z=2.117,P=0.034]and albumin[32.2(8.2)g/L vs.36.9(6.2)g/L,Z=5.484,P<0.000],while the other blood biochemical indicators showed no significant difference(all P>0.05).The elderly group versus non-elderly group had significantly higher level of serum anti-hepatitis E virus IgM[17.3(53.0) vs.7.9(24.4),Z=2.351,P=0.019),while the positive rate of serum anti-hepatitis E virus IgG had no significant difference(Х^2=1.284,P=0.526).Conclusions Some blood biochemical and immunological indicators in elderly patients with hepatitis E are significantly different from those of non-elderly patients,but clinical features have no difference between the two groups.Changes in relevant indicators should be considered during the clinical diagnosis and treatment.

关 键 词：肝炎 戊型 生物学标记 

分 类 号：R512.6[医药卫生—内科学]