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纸质出版:2010
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谭顺,谭文婷,刘明,毛青,邓国宏.176例甲型肝炎临床特征分析[J].陆军军医大学学报(原第三军医大学学报),2010,32(22):2409-2412.
Tan Shun,Tan Wenting,Liu Ming,Mao Qing,Deng Guohong.Clinical characteristics of hepatitis A: report of 176 cases[J].J Amry Med Univ (J Third Mil Med Univ),2010,32(22):2409-2412.
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(P0.05);重叠组ALT 5~10 ULN、TBIL10ULN比率及重型肝炎比率均显著高于单纯组(χ
2
值分别为8.127、4.159、6.999,P0.05),而单纯组ALT10ULN、TBIL 5~10ULN比率显著高于重叠组(χ
2
值分别为6.903、5.033,P0.05)。重叠组中,HBeAg
-
与HBeAg
+
患者比例为2.1︰1,HBeAg
-
患者占67.4%;HBV DNA≥10
4
拷贝/ml与HBV DNA10
4
拷贝/ml患者比例为1.8∶1,HBV DNA10
4
拷贝/ml患者约占34.8%;HBeAg
-
与HBeAg
+
、HBV DNA≥10
4
拷贝/ml与HBV DNA10
4
拷贝/ml分类比率均无统计学差异(P0.05)。 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
includin
g 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≥10
4
to HBV DNA10
4
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.
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