慢性乙型肝炎重叠甲、戊型肝炎对肝功能及其预后的影响
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贺新春

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R512.6

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Impact of hepatitis A or E viral superinfection on liver function and prognosis of patients with chronic hepatitis B
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    摘要:

    目的了解慢性乙型肝炎患者重叠感染甲型或戊型肝炎对其肝功能及病情转归的影响。方法收集慢性乙型肝炎重叠甲型肝炎(慢乙肝+甲肝组)患者45例、慢性乙型肝炎重叠戊型肝炎(慢乙肝+戊肝组)患者47例和单纯慢性乙型肝炎(慢乙肝组)患者60例进行对比分析。应用酶联免疫吸附试验(ELISA)检测乙型肝炎病毒(HBV)标志物及抗HAV IgM、抗HEV IgM,荧光定量聚合酶链反应 (FQPCR) 法检测HBV载量,同时检测肝功能和凝血酶原时间。结果慢乙肝+戊肝组患者的总胆红素、转氨酶增高,清蛋白下降,总胆红素、转氨酶恢复正常时间和凝血酶原时间延长,重型肝炎发病率及病死率均显著高于慢乙肝+甲肝组和慢乙肝组(P<0.05)。慢乙肝+甲肝组患者的总胆红素、转氨酶增高,总胆红素、转氨酶恢复正常时间较慢乙肝组显著延长(P<0.05),但两组的清蛋白下降、凝血酶原时间延长、重型肝炎发病率及病死率差异无统计学意义(P>0.05)。结论甲型肝炎重叠感染对慢性乙型肝炎的转氨酶、胆红素有一定影响;戊型肝炎重叠感染对慢性乙型肝炎的肝功能及其预后均有严重的影响。

    Abstract:

    ObjectiveTo realize the impact of hepatitis A or E viral superinfection on liver function and prognosis of patients with chronic hepatitis B(CHB).Methods45 CHB patients with hepatitis A superinfection (CHB+HA group), 47 CHB patients with hepatitis E superinfection(CHB+HE group),and 60 patients with CHB alone (CHB group) were studied and compared. HBsAg, antiHBs, HBeAg, antiHBe, antiHBc, antiHAV IgM and antiHEV IgM were detected by enzymelinked immunosorbent assay(ELISA), HBV DNA was detected by fluorescent quantitative polymerase chain reaction (FQPCR). Liver function and prothrombin time(PT) were detected.ResultsCompared with CHB+HA and CHB groups, in CHB+HE group, the total bilirubin(TB) and aminotransferase increased, albumin(ALB) decreased, the time of normalization of TB and aminotransferase as well as PT prolonged, morbidity and mortality of severe hepatitis increased (P<0.05). In CHB+HA group, TB and aminotransferase increased, the time of normalization of TB and aminotransferase prolonged significantly compared with CHB group(P<0.05), but difference in decrease in ALB, prolongation of PT, and morbidity and mortality of severe hepatitis between two groups were not significantly different(P>0.05).ConclusionThe superinfection of hepatitis A has certain impact on TB and aminotransferase; chronic hepatitis B patients superinfected with hepatitis E virus have more severe hepatic damage and higher mortality.

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贺新春,刘建湘,蒋黎.慢性乙型肝炎重叠甲、戊型肝炎对肝功能及其预后的影响[J]. 中国感染控制杂志,2013,12(4):278-280. DOI:10.3969/j. issn.1671-9638.2013.
HE Xinchun, LIU Jianxiang, JIANG Li. Impact of hepatitis A or E viral superinfection on liver function and prognosis of patients with chronic hepatitis B[J]. Chin J Infect Control, 2013,12(4):278-280. DOI:10.3969/j. issn.1671-9638.2013.

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  • 收稿日期:2012-08-07
  • 最后修改日期:2012-12-22
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  • 在线发布日期: 2013-07-30
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