CAJ | 학술논문

目的了解HBV和HCV不同模式重叠感染患者临床特征的差异.方法回顾分析中山大学附属第三医院1999年5月至2010年5月HCV和HBV重叠感染患者186例.统计分析不同病毒学模式重叠感染患者的人口学、流行病学、实验室检查和病理学表现,数据处理采用t检验和x2检验等.结果 186例HBV和HCV重叠感染患者中,HBV DNA(-)/HCV RNA(-)组66例(35.5%),HBV DNA(+)/HCV RNA(+)组8例(4.3%),HBV DNA(+)/HCV RNA(-)组68例(36.6%),HBV DNA(-)/HCV RNA(+)组44例(23.7%).4组在性别构成、并发症发生率、吸毒传播途径、ALT、TBil、PTA及HBeAg阴转率方面均差异有统计学意义(F或x2值分别为11.578、8.451、11.738、2.669、5.102、4.254和18.413;均P<0.05).HCV RNA(-)与HCV RNA (+)患者相比,吸毒感染分别为49.3%、23.1%(x2=9.987,P=0.002);输血感染分别为29.9%、46.2%(x2=4.412,P=0.036).HBVDNA(-)时,HCV RNA(-)和HCV RNA(+)患者的ALT中位数分别为177 U/L和62 U/L(t=2.200,P<0.05),TBil中位数分别为133μmol/L和20/μmol/L(t=3.608,P<0.05),PTA分别为70.6%±27.7%和83.3%±27.8%(t=-1.982,P<0.05).HCV RNA水平不影响HBeAg血清学转换(t=0.707,P>0.05).HBV DNA(-)患者HBeAg阴转率为85.5%,明显高于HBV DNA(+)患者的59.2%(x2=16.393,P<0.05).结论 HBV和HCV重叠感染患者4种病毒学模式中,以HBV DNA(+/一)/HCV RNA(-)模式为主.HBV DNA水平与疾病严重程度无关,但与疾病进展和转归有关.HCV RNA水平越低,肝功能越差,病情越重.HBV DNA与HBeAg阴转相关,而HCV RNA与HBeAg血清学转换无关.
목적 료해HBV화HCV불동모식중첩감염환자림상특정적차이.방법 회고분석중산대학부속제삼의원1999년5월지2010년5월HCV화HBV중첩감염환자186례.통계분석불동병독학모식중첩감염환자적인구학、류행병학、실험실검사화병이학표현,수거처리채용t검험화x2검험등.결과 186례HBV화HCV중첩감염환자중,HBV DNA(-)/HCV RNA(-)조66례(35.5%),HBV DNA(+)/HCV RNA(+)조8례(4.3%),HBV DNA(+)/HCV RNA(-)조68례(36.6%),HBV DNA(-)/HCV RNA(+)조44례(23.7%).4조재성별구성、병발증발생솔、흡독전파도경、ALT、TBil、PTA급HBeAg음전솔방면균차이유통계학의의(F혹x2치분별위11.578、8.451、11.738、2.669、5.102、4.254화18.413;균P<0.05).HCV RNA(-)여HCV RNA (+)환자상비,흡독감염분별위49.3%、23.1%(x2=9.987,P=0.002);수혈감염분별위29.9%、46.2%(x2=4.412,P=0.036).HBVDNA(-)시,HCV RNA(-)화HCV RNA(+)환자적ALT중위수분별위177 U/L화62 U/L(t=2.200,P<0.05),TBil중위수분별위133μmol/L화20/μmol/L(t=3.608,P<0.05),PTA분별위70.6%±27.7%화83.3%±27.8%(t=-1.982,P<0.05).HCV RNA수평불영향HBeAg혈청학전환(t=0.707,P>0.05).HBV DNA(-)환자HBeAg음전솔위85.5%,명현고우HBV DNA(+)환자적59.2%(x2=16.393,P<0.05).결론 HBV화HCV중첩감염환자4충병독학모식중,이HBV DNA(+/일)/HCV RNA(-)모식위주.HBV DNA수평여질병엄중정도무관,단여질병진전화전귀유관.HCV RNA수평월저,간공능월차,병정월중.HBV DNA여HBeAg음전상관,이HCV RNA여HBeAg혈청학전환무관.
Objective To understand the clinical features of hepatitis B virus(HBV)/hepatitis C virus(HCV)coinfected patients with different virological profiles.Methods The clinical data of 186 patients with HBV/HCV coinfection from May 1999 to May 2010 in the Third Affiliated Hospital of Sun Yat-Sen University were analyzed retrospectively.The demographic data,epidemiological data,laboratory results and pathological index were analyzed.The statistical analysis was done using t test and chi square test.Results A total of 186 patients were divided into 4 groups:66(35.5%)in HBV DNA(-)/HCV RNA(-)group,8(4.3%)in HBV DNA(+)/HCV RNA(+)group,68(36.6%)in HBV DNA(+)/HCV RNA(-)group and 44(23.7%)in HBV DNA(-)/HCV RNA(+) group.The gender composition,complication incidence,transmission among drug users,alanine aminotransferase(ALT)level,total bilirubin(TBil)level,prothrombin activity(PTA)and hapatitis B e antigen(HBeAg)negative rate were all significantly different among four groups(F or x2=11.578,8.451,11.738,2.669,5.102,4.254 and 18.413,respectively;all P<0.05).In groups of HCV RNA(-)and HCV RNA(+),the proportions of patients infected through drug abuse were 49.3%and 23.1%,respectively(x2=9.987,P:0.002)and blood transfusion transmission were 29.9%and 46.2%,respectively(x2=4.412,P=0.036).When HBV DNA was negative,the median ALT levels in HCV RNA(-)and HCV RNA(+)patients were 177 U/L and 62 U/L,respectively(t=2.200,P<0.05),median TBil levels were 133 μmol/L and 20μmol/L,respectively (t=3.608,P<0.05)and PTA were 70.6%±27.7%and 83.3%±27.8%,respectively(t=-1.982,P<0.05).The HBeAg negative rate was not affected by HCV RNA levels(t=0.707,P>0.05).The HBeAg negative rate in HBV DNA(-)patients was 85.5%,which was higher than that in HBV DNA(+)patients(59.2%)(x2=16.393,P<0.05).Conclusions HBV DNA(+/-)/HCV RNA(-)profile were major components in HBV/HCV confection.HBV DNA level is related to disease progression and prognosis,but not relate to disease severity.Liver function damage and disease severity are aggravated with HCV RNA level decreases.HBV DNA level is related to HBeAg negative rate,while HCV RNA level is not related to HBeAg seroconversion rate.