摘要
目的 通过对了型肝炎病毒（ＨＤＶ）感染的乙型肝炎患者临床特点分析，了解ＨＤＶ感染特征和ＨＤＶ致病机理。方法对合并ＨＤＶ感染的５０７例乙型肝炎患者各临床类型肝炎的发生、预后、临床表现、生物化学指标、肝炎病毒标志物等作统计分析，以２１３例单纯ＨＢＶ感染的乙型肝炎患者作对照。结果ＨＤＶ感染后重型肝炎、肝硬化的发生率和病死率、及发生出血、腹水、并发症和ＡＬＴ反复增高及增高幅度均较ＨＤＶ阴性者高（Ｐ＜０．０１或Ｐ＜０．０５），重度慢性肝炎和重型肝炎患者的生物化学指标异常也较对照组明显（Ｐ＜０．０１）。血清ＨＢｅＡｇ（Ｐ＜０．０１）。急性肝炎、重型肝炎和肝硬化ＨＤＡｇ（＋）、ＨＢｅＡｇ（－）表达高于ＨＤＡｇ、ＨＢｅＡｇ均阳性者（Ｐ＜０．０１或Ｐ＜０．０５）。结论 ＨＤＶ感染后重度慢性肝炎、重型肝炎和肝硬化的发生率高，预后差；ＨＤＶ感染可抑制ＨＢＶ复制或ＨＢｅＡｇ表达；ＨＤＶ的直接细胞毒性作用在急性肝炎中可能起主要致病作用，在合并有ＨＤＶ感染的乙型肝炎患者病情加重、病死率增高和慢性化过程中，ＨＤＶ可能起主要促进作用。
Objective To explore the pathogenesis of hepatitis D virus by analyzing the clinic characteristics of 507 cases of hepatitis B (HB) with hepatitis D virus (HDV) infection. Methods The occurrence of different types of hepatitis, the prognosis, clinical features, major biochemistry results, and hepatitis virus marks were analyzed in 507 cases of HB with positive HDV and compared with 213 cases of HB with negative HDV. Results The incidence and the mortality of serious chronic hepatitis, severe hepatitis, and liver cirrhosis were all higher in the HB patients with positive HDV than negative one. The incidence of bleeding, ascites, hepat-coma complication, and the level of ALT were higher in HDV- positive patients than in HDV-negative patients (P < 0.01 or P < 0.05), and the changes of the major biochemistry results were more obvious than the same types of hepatitis B with negative HDV (P < 0.01). The detection rate for HBeAg in serum of the patients positive for HDV was obviously lower than that of the patients negative for HDV(P < 0.01). In patients with acute hepatitis, severe hepatitis, and liver cirrhosis, the expression of positive HDAg and negative HBeAg was obviously higher than that of positive HDAg and HBeAg (P < 0.01 or P < 0.05). Conclusions After HDV infection, the incidence and poor prognosis of serious chronic hepatitis, severe hepatitis, and live7ci,rhosis increase. HDV infection can inhibit the replication of HBV DNA or HBeAg expression. The effects of direct cytotoxicity of HDV on hepatocytes may play a major pathogenic role in acute hepatitis and in aggravating illness status to severe type.
出处
《中华肝脏病杂志》
CAS
CSCD
2001年第1期34-36,共3页
Chinese Journal of Hepatology
