丁型肝炎病毒HDV-IgM筛查状况与感染患者临床特征分析  

Analysis of the screening status of hepatitis D virus HDV-IgM and clinical characteristics of infected patients

作　　者：刘新[1] 田树萍[1] 郭继桥[1] 刘辉[1] 刘宁[1] 冯霞[1] 于艳华[1] 娄金丽[1] LIU Xin;TIAN Shuping;GUO Jiqiao;LIU Hui;LIU Ning;FENG Xia;YU Yanhua;LOU Jinli(Clinical Laboratory Center,Beijing YouAn Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院临床检验中心,北京100069

出　　处：《胃肠病学和肝病学杂志》2024年第5期571-576,共6页Chinese Journal of Gastroenterology and Hepatology

基　　金：北京市优秀人才青年骨干项目(2018000021469G287)。

摘　　要：目的了解乙型肝炎人群丁型肝炎病毒感染筛查情况及感染患者临床特征。方法回顾性分析2014年1月至2023年10月我院乙型肝炎病毒感染(HBsAg阳性)患者丁型肝炎感染筛查(HDV-IgM)结果,分析筛查比例变化及阳性结果临床情况,收集丁型肝炎感染患者(HDV-IgM阳性)的临床资料,与HDV-IgM阴性乙型肝炎患者比较,总结丁型肝炎感染患者的临床特点。结果近10年乙型肝炎感染患者中HDV-IgM的平均筛查比例仅有3.60%(18533/514271),其中2014年的筛查比例最高,为6.67%(3407/51073),2020年的筛查比例最低,为1.84%(855/46413)。2014-2020年筛查比例呈逐年下降的趋势,2021年开始逐渐上升。HDV-IgM筛查阳性共45例,年龄(43.31±13.59)岁(1~80岁),男23例,女22例,其中有1例是乙肝阴性(HBsAg和HBV DNA均阴性)。地区分布是居住在北京的国际友人(主要为蒙古国)27例(60.00%);内蒙古自治区11例(24.44%);北京市4例(8.89%);河北省2例(4.44%);河南省1例(2.22%)。HDV-IgM阳性组与HDV-IgM阴性组比较,年龄、性别、HBV DNA水平差异无统计学意义情况下,HDV-IgM阳性组HBeAg阳性率明显低于HDV-IgM阴性组(P=0.001),且HDV-IgM阳性组ALT、AST和GGT高于HDV-IgM阴性组(P均<0.001)。HDV-IgM阳性组与HDV-IgM阴性组乙肝五项模式分布具有显著性差异(P<0.05)。结论近10年,丁型肝炎的筛查率低,阳性率不高,发病率高的地区应重视HDV的筛查,提高诊断率。HDV感染会加重肝炎病情程度,值得重视。Objective To comprehend the screening of hepatitis D virus infection in the hepatitis B population and the clinical characteristics of infected patients.Methods The results of hepatitis D infection screening(HDV-IgM)in patients with hepatitis B virus infection(HBsAg positive)were retrospectively analyzed in our hospital from Jan.2014 to Oct.2023.The change of screening proportion and the clinical situation of positive results were analyzed.The clinical data of patients with hepatitis D infection(HDV-IgM positive)were compared with the data in hepatitis B patients with HDV-IgM negative.The clinical characteristics of patients with hepatitis D infection were summarized.Results In recent 10 years,the average screening proportion of HDV-IgM among hepatitis B infected patients was only 3.60%(18533/514271).The highest screening proportion was 6.67%(3407/51073)in 2014,and the lowest screening proportion was 1.84%(855/46413)in 2020.The screening proportion showed a decreasing trend from 2014 to 2020 and gradually increased from 2021 to 2023.There were 45 HDV-IgM positive patients,including 23 males and 22 females with ages ranging from(43.31±13.59)years old(1-80 years old).There was a patient with negative hepatitis B virus(both HBsAg and HBV DNA were negative).Regional distribution:27 cases(60.00%)international individuals(mainly from Mongolia)residing in Beijing;11 cases(24.44%)in Inner Mongolia Autonomous Region;4 cases(8.89%)in Beijing;2 cases(4.44%)in Hebei Province;1 case(2.22%)occurred in Henan Province.Compared with the HDV-IgM negative group,the HBeAg positive rate in the HDV-IgM positive group was significantly lower(P=0.001),and the ALT,AST,GGT levels were higher(all P<0.001).The distribution of the five patterns of hepatitis B differed significantly between HDV-IgM positive and negative groups was regions(P<0.05).Conclusion In recent 10 years,the screening rate of hepatitis D has been low,and the positive rate is not high.Regions with high incidence rates should focus on HDV screening to improve diagnostic r

关 键 词：丁型肝炎 乙型肝炎 HDV-IgM 筛查 

分 类 号：R575[医药卫生—消化系统]