摘要
目的了解我院收治甲型肝炎患者的临床特征,比较单纯甲型肝炎与甲型和乙型重叠感染的异同。方法对176例甲型肝炎患者流行病学资料进行回顾性分析,分别比较单纯甲型肝炎与甲型和乙型重叠感染时的生化学指标、ALT和TBIL分类比率及重型肝炎比率的差异。结果甲型肝炎发病以青壮年为主,男女比例为2.4∶1,甲型和乙型重叠感染占52.3%。单纯甲型肝炎与甲型和乙型重叠感染的男女比例、年龄有统计学差异(P<0.05);重叠组ALT5～10ULN、TBIL>10ULN比率及重型肝炎比率均显著高于单纯组(χ2值分别为8.127、4.159、6.999,P<0.05),而单纯组ALT>10ULN、TBIL5～10ULN比率显著高于重叠组(χ2值分别为6.903、5.033,P<0.05)。重叠组中,HBeAg-与HBeAg+患者比例为2.131,HBeAg-患者占67.4%;HBV DNA≥104拷贝/ml与HBV DNA<104拷贝/ml患者比例为1.8∶1,HBV DNA<104拷贝/ml患者约占34.8%;HBeAg-与HBeAg+、HBV DNA≥104拷贝/ml与HBV DNA<104拷贝/ml分类比率均无统计学差异(P>0.05)。结论甲型肝炎发病重叠感染患者更多见,甲型和乙型重叠感染时较单纯甲型肝炎肝功能损伤更重,更容易发生重型肝炎。
Objective To investigate the incidence of hepatitis A and the differences between hepatitis A in non-HBV carriers and in HBV carriers. Methods The clinical characteristics of 176 cases with hepatitis A were analyzed who admitted in our institute from April 2004 to December 2009. There were 59 cases positive to anti-HAV IgM and 92 cases positive to anti-HAV IgM and HBsAg. The hepatitis functions, including alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, total bilirubin （TBIL） and direct bilirubin （DBIL） were measured. And the differences of hepatitis A in non-HBV carriers and in HBV carriers were compared. Upper limit of normal （ULN） of ALT and TBIL was used to categorize the patients. Results Incidence of hepatitis A were common in adults. The ratio of male to female was 2.4∶1. Hepatitis A in HBV carriers accouted for 52.3% （92/187）, and the other 25 hepatitis A patients were accompanied with hepatitis C, D, E, Epstein-Barr virus infection, autoimmune/alcoholic hepatitis, or intrahepatic cholestasis of pregnancy. There were more ATL 5 to 10ULN, TBIL 10ULN, and severe hepatitis in HBV carriers than in non-HBV carrier （Chi square=8.127, 4.159, 6.999, P0.05）. More ALT10ULN and TBIL 5 to 10ULN were found in non-HBV carrier than in HBV carriers （Chi square=6.903, 5.033, P0.05）. In HBV carrier, the ratio of HBeAg negative to positive was 2.1∶1, with former accounting for 67.4%, and the ratio of HBV-DNA≥104 to HBV DNA104 was 1.8∶1, with the later accouting for 34.8%. The categorization with HBeAg and HBV DNA amount had no significant difference （P0.05）. Conclusion The hepatitis A in HBV carriers are more common than hepatitis A in non non-HBV carriers. Hepatitis A in HBV carriers may cause a heavier liver injury and easier to develop into severe hepatitis than that in non-HBV carriers.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2010年第22期2409-2412,共4页
Journal of Third Military Medical University
基金
"十一五"国家科技支撑计划(2008BAI52B03)
全军医学科研"十一五"计划青年基金(06Q056)~~
