急性戊型病毒性肝炎合并葡萄糖-6-磷酸脱氢酶缺乏2例分析并文献复习  

A report and literature review of 2 cases of acute viral hepatitis E with glucose-6 phosphate dehydrogenase deficiency

作　　者：李盼盼 张艳茹 陈丽 吴彪[1] LI Pan-pan;ZHANG Yan-ru;CHEN Li;WU Biao(Department of Infection,Hainan General Hospital,Hainan Affiliated Hospital of Hainan Medical University,Haikou,Hainan 570311,China)

机构地区：[1]海南省人民医院,海南医学院附属海南医院感染科,国家卫健委热带病防治重点实验室,海南海口570311

出　　处：《中国热带医学》2021年第11期1110-1113,共4页China Tropical Medicine

基　　金：海南省自然科学基金项目(No.SQ2018MSXM0258)。

摘　　要：目的分析急性戊型病毒性肝炎合并G6PD(glucose-6 phosphate dehydrogenase,葡萄糖-6-磷酸脱氢酶)缺乏2例患者出现高胆红素血症、溶血性贫血、急性肾功能衰竭等并发症情况以及治疗及转归,为该类患者的诊治提供依据。方法选择海南省人民医院感染科收治的急性戊型病毒性肝炎合并G6PD缺乏的患者2例,分析其一般情况、临床表现、实验室检查、诊断、并发症、治疗及预后等临床资料。结果该研究中2例患者在病程中均出现高胆红素血症、溶血性贫血。其中1例出现急性肾功能衰竭,经积极护肝退黄、抗感染等药物治疗,以及人工肝、血液透析等综合治疗后痊愈。2例患者痊愈后院外随访均未遗留后遗症。结论急性戊型病毒性肝炎是一种预后良好的自限性疾病,但该类患者合并G6PD缺乏时可出现高胆红素血症、溶血性贫血、急性肾功能衰竭等并发症,临床救治需引起重视,应筛查所有急性戊型肝炎患者中G6PD缺乏的,充分评估、尽早诊断和及时治疗,警惕发展为重型肝炎及出现严重溶血、肾功能衰竭等,及早采取预防急性肾功能衰竭的措施,提高治疗成功率。Objective To analyze the hyperbilirubinemia,hemolytic anemia,acute renal failure and other complications in patients with acute hepatitis E and glucose-6 phosphate dehydrogenase(G6PD)deficiency,so as to provide reference for the diagnosis and treatment of such patients.Methods Two patients with acute hepatitis E and G6PD deficiency who were discharged from the Infectious Department of Hainan General Hospital were recruited as the study objects,the general conditions,clinical symptoms,results of clinical laboratory tests,diagnosis,complications,treatment and prognosis were observed and analyzed.Results In this study,both patients presented hyperbilirubinemia and hemolytic anemia,one patient developed acute renal failure,and were cured after active drug treatment and artificial liver,hemodialysis and other comprehensive treatment,without sequelae when follow-up.Conclusions Acute viral hepatitis E is a self-limited disease with a good prognosis,but hyperbilirubinemia,hemolytic anemia,acute renal failure and other serious complications may occur in patients with acute hepatitis E and G6PD deficiency,this should be laid more stresses on and full evaluation,early diagnosis and prompt treatment should be undertaken,screening all patients'G6PD,alerting to develop into severe hrpatitis,hemolysis,renal failure and so on,taking the measure that prevents acute renal function failure as soon as possible to increase the successful rate.

关 键 词：葡萄糖-6-磷酸脱氢酶 戊型肝炎 溶血性贫血 肾功能衰竭 

分 类 号：R575.1[医药卫生—消化系统]