50例老年戊型肝炎临床特点与血清学特征分析  

Analysis of clinical and serological characteristics of hepatitis E in 50 elderly patients

作　　者：陈吐芬 张波 CHEN Tufen;ZHANG Bo(Department of Infectious Diseases,Central Theater General Hospital of Chinese People’s Liberation Army,Wuhan 430070,China)

机构地区：[1]中国人民解放军中部战区总医院感染科,湖北省武汉市430070

出　　处：《实用老年医学》2024年第7期722-726,共5页Practical Geriatrics

摘　　要：目的 探讨老年戊型病毒性肝炎的临床特点及血清学特征。方法 比较50例老年戊型病毒性肝炎病人(老年组)和50例中青年戊型病毒性肝炎病人(中青年组)的临床特征及血清生化指标差异。结果 老年组肝衰竭、皮肤瘙痒、合并症和并发症的发生率及住院时间、病程等均高于中青年组,但发热的发生率低于中青年组(P<0.01)。治疗前,老年组总胆红素(TBiL)、肌酐(Cr)、凝血酶原时间(PT)、凝血酶原时间国际标准化比值(INR)均高于中青年组(P均<0.05),而ALT、血清白蛋白(ALB)水平均低于中青年组(P均<0.05)。治疗后,2组病人TBiL、ALT、AST、γ-谷氨酰转肽酶(γ-GGT)、碱性磷酸酶(AKP)水平均较治疗前显著降低,ALB水平较治疗前明显升高(P均<0.05),且中青年组TBiL、AKP、PT、INR水平降低更为明显(P均<0.05)。结论 老年戊型病毒性肝炎病人皮肤瘙痒更显著,黄疸程度深,低蛋白血症多见,肝衰竭发生率高,合并症和并发症多见,病程延长,恢复缓慢,多数病人预后良好。Objective To investigate the clinical and serological characteristics of hepatitis E in the elderly patients.Methods The differences in the clinical characteristics and serum biochemical indexes between 50 elderly patients with hepatitis E(elderly group)and 50 young and middle-aged patients with hepatitis E(young and middle-aged group)were analyzed.Results The incidence rate of liver failure,skin itching,comorbidities and complications and the hospital stay and disease course were higher while the incidence rate of fever was lower in elderly group than that in young and middle-aged group(P<0.01).Before treatment,the levels of total bilirubin(TBiL),creatinine(Cr),ptrothrombin time(PT),international normalized ratio(INR)were significantly higher and the levels of alanine aminotransferase(ALT)and albumin(ALB)were lower in elderly group than those in young and middle-aged group(P<0.05).After treatment,the levels of TBiL,ALT,aspartate aminotransferase(AST),gamma-glutamyl transferase(γ-GGT),alkaline phosphatase(AKP)in the two groups were significantly lower and the level of ALB was significantly higher than that before treatment(P<0.05),and the levels of TBiL,AKP,PT,INR decreased more significantly in young and middle-aged group(P<0.05).Conclusions The elderly patients with hepatitis E have obvious skin pruritus,deep jaundice,more hypoalbuminemia,high incidence of liver failure,common complications,prolonged course of disease and slow recovery,and most patients have a good prognosis.

关 键 词：老年人 戊型病毒性肝炎 肝衰竭 临床特点 血清学特征 预后 

分 类 号：R512.65[医药卫生—内科学]