2010至2019年重庆地区戊型肝炎病毒感染血清学特征分析  

Analysis of serological characteristics of hepatitis E virus infection in Chongqing during 2010 to 2019

作　　者：石杉 刘潘婷 史静[1] 邹麟[1] 陈瀑[1] Shi Shan;Liu Panting;Shi Jing;Zou Lin;Chen Pu(Department of Laboratory Medicine,The First Affiliated Hospital of Chongqing Medical University)

机构地区：[1]重庆医科大学附属第一医院检验科,重庆400016

出　　处：《重庆医科大学学报》2021年第9期1080-1084,共5页Journal of Chongqing Medical University

摘　　要：目的 :从血清学特征分析2010至2019年重庆地区人群戊型肝炎病毒(hepatitis E virus,HEV)感染趋势,探讨抗-HEV抗体(IgM、IgG)在临床戊型肝炎(hepatitis E,HE)中的诊断价值。方法:回顾性分析2010至2019年重庆医科大学附属第一医院血清学抗-HEV抗体(IgM、IgG)实验室数据及临床资料;分析单抗-HEV IgM阳组、单抗-HEV IgG阳组、抗-HEV IgM和IgG双阳组及对照组之间肝功能指标的差异性以及抗-HEV抗体阳性结果与临床HE诊断的符合率。结果:2010至2019年抗-HEV抗体总阳性率8.4%(IgM阳性率2.4%,IgG阳性率6.8%),HEV感染呈逐年上升趋势,以抗-HEV IgG阳性率上升为主,2012年最低,为1.7%;2018年最高,为12.4%;抗-HEV IgM阳性率无上升趋势,2016年最低,为1.2%;2010年最高,为4.2%。HEV感染季节和性别分布无统计学差异(P>0.05)。50岁以下人群HEV感染率随年龄增长而升高(P<0.017),50岁以上人群维持在较高水平。双阳组的HE诊断符合率最高,为96.3%;单抗-HEV IgG阳组最低,为3.2%(P<0.017)。结论:HEV感染逐年增加,以既往感染为主,单项抗-HEV IgG指标的诊断价值有限,临床HE的诊断应以肝功能异常同时伴抗-HEV双阳或单项抗-HEV IgM阳为主要标准,为了进一步研究HEV感染特征应推进HEV RNA和HEV Ag的检测。Objective:To analyze the trend of hepatitis E virus(HEV) infection in Chongqing from 2010 to 2019,and to explore the diagnostic value of anti-HEV antibodies(IgM,IgG) in clinical hepatitis E(HE). Methods:The data and clinical medical records of anti-HEV antibodies(IgM and IgG) collected from The First Affiliated Hospital of Chongqing Medical University between 2010 and2019 was analyzed retrospectively. The statistical differences in hepatic function index were analyzed among the single anti-HEV IgM positive group,the single anti-HEV IgG positive group,the anti-HEV IgM and IgG double positive group,and the control group,as well as the coincidence rate between positive anti-HEV antibody and clinical HE diagnosis was determined. Results : The total positive rate of anti-HEV antibodies was 8.4%(IgM:2.4%,IgG:6.8%) during this period,indicating that HEV showed an upward trend year by year,and the positive rate of anti-HEV IgG was mainly cause with the lowest 1.7% in 2012 and the highest 12.4% in2018,but the positive rate of anti-HEV IgM showed no upward trend with the lowest 1.2% in 2016 and the highest 4.2% in 2010.There was no statistical differences between HEV infection season and genders(P>0.05). The HEV infection rate of the people under 50 years old was increased with age(P<0.017),and the people more than 50 years old maintained at a high level. The diagnostic coincidence rate was as the highest as 96.3% of the double positive group,and as the lowest as 3.2% in the single anti-HEV IgG positive group( P < 0. 017). Conclusion : The cases of HEV infection were increased annually, which mainly came from previous infections. The single anti-HEV IgG positive indicator has limited diagnostic value for HE infection. The clinical diagnosis of HE should be based on the combination of liver dysfunction with the anti-HEV double positive or a single anti-HEV IgM positive.Moreover,the detection of HEV RNA and HEV Ag should be considered for the further study of HEV infection.

关 键 词：戊型肝炎病毒 抗-HEV抗体 感染率 戊型肝炎 

分 类 号：R512.6[医药卫生—内科学]