CAJ | 학술논문

目的:观察和分析急性戊型肝炎的临床特点.方法:调查急性戊型肝炎患者221例的流行病学资料. 分别比较年龄18岁以下、18-60岁和60岁以上患者组, 单纯急性戊肝组和重叠慢乙型肝炎、酒精肝组以及单项抗-HEV-IgG阳性组与抗-HEV-IgM阳性组病例的病程、生化学指标、预后等方面的差异.结果:221例急性戊型肝炎患者中18岁以上者188例, 占84.8%; 男女之比3.92∶1; 职业分布特点是外出务工者108例, 占48.8%; 2-5月份发病患者数占当年发病患者数的67.8%, 随患病年龄增加, 表现出住院时间延长, 病死率增加, ALT、ALB水平呈下降趋势, 各组比较均有显著差异. 重叠乙型肝炎和酒精肝组的重肝发生率及死亡率分别为7.8%、1.9%和6.0%、3.0%, 明显高于单纯戊肝组的2.1%和0.7%. 抗-HEV-IgG阳性与抗-HEV-IgM阳性病例的临床表现和各项生化学指标比较无显著性差异.结论:急性戊型肝炎成年人多发, 外务工者高发, 有冬春发病高峰. 大多数患者预后良好, 老年戊型肝炎及在乙型肝炎、酒精肝基础上重叠戊肝病毒感染可能是影响患者预后的主要因素.
목적:관찰화분석급성무형간염적림상특점.방법:조사급성무형간염환자221례적류행병학자료. 분별비교년령18세이하、18-60세화60세이상환자조, 단순급성무간조화중첩만을형간염、주정간조이급단항항-HEV-IgG양성조여항-HEV-IgM양성조병례적병정、생화학지표、예후등방면적차이.결과:221례급성무형간염환자중18세이상자188례, 점84.8%; 남녀지비3.92∶1; 직업분포특점시외출무공자108례, 점48.8%; 2-5월빈발병환자수점당년발병환자수적67.8%, 수환병년령증가, 표현출주원시간연장, 병사솔증가, ALT、ALB수평정하강추세, 각조비교균유현저차이. 중첩을형간염화주정간조적중간발생솔급사망솔분별위7.8%、1.9%화6.0%、3.0%, 명현고우단순무간조적2.1%화0.7%. 항-HEV-IgG양성여항-HEV-IgM양성병례적림상표현화각항생화학지표비교무현저성차이.결론:급성무형간염성년인다발, 외무공자고발, 유동춘발병고봉. 대다수환자예후량호, 노년무형간염급재을형간염、주정간기출상중첩무간병독감염가능시영향환자예후적주요인소.
AIM: To investigate and analyze clinical characteristics of patients with acute hepatitis E infection. METHODS: Epidemiological data of 221 patients with acute hepatitis E infection were collected. Comparisons were performed to find the differences in disease course, biochemical index and prognosis amongst diverse age groups (below 18-years-old, between 18 and 60, above 60), different status of disease groups (hepatitis E infection only, hepatitis E infection accompanied by hepatitis B infection/alcohol hepatitis), and different antibody groups (anti-HEV-IgG positive, anti-HEV-IgM positive). RESULTS: 84.8% (188/221) of patients were over 18 years old, and the ratio of male/female was 3.92∶1. Then the characteristics of occupation distribution were people working outside, 108 patients (48.8%) in this group. In addition, season was another factor that influenced hepatitis E infection, especially from February to May during which there were 67.8% patients infected with hepatitis E. The clinical features were summarized into three points: prolonged disease course, an increased mortality and decreased levels of ALT/ALB were associated with older age. Second, the prevalence of severe liver disease and mortality in the group of hepatitis E infection accompanied by hepatitis B (7.8%, 1.9%) and alcohol hepatitis (6.0%, 3.0%) were higher than those in hepatitis E infection group (2.1%, 0.7%). In addition, there was no significant difference in clinical symptoms and biochemical indexes between anti-HEV-IgG positive and anti-HEV-IgM positive groups. CONCLUSION: Four epidemiological characteristics, including adult, male, people working outside and winter/spring, are found to be associated with hepatitis E infection. The prognosis of disease in the majority of patients is favorable, old age and coexistence with hepatitis B and alcohol hepatitis can be seen as the factors which affect the prognosis.