CAJ | 학술논문

目的：通过比较单纯乙型肝炎病毒（HBV）和乙丁型肝炎病毒（HBV HDV）重叠感染的患者血清中 ALT、HBV DNA及 HBV 血清学标志（HBVM）等的异同，了解 HBV HDV 重叠感染特点，初步探讨 HDV 的致病机理。方法对95例 HBV HDV 重叠感染的患者生物化学指标、肝炎病毒标志物等作统计分析，以100例单纯 HBV 感染患者作为对照。结果在95例重叠感染者中，慢性乙型肝炎发生率最高，占66．32％，肝硬化次之。按 HBV DNA 载量分类，两者差异无统计学意义（P ＞0．05），重叠感染组 ALT 异常率与 HBV DNA 呈正相关（r ＝0．90，P ＜0．05）。重叠感染组以 HBeAg 阴性模式为主（P ＜0．05），按HBsAg＞250 IU/mL 统计，差异无统计学意义（P ＞0．05）；按 HBsAg＞250 IU/mL 且 HBeAg ＞1 S/CO 统计时，单纯 HBV 组高于重叠感染组（P ＜0．05）。HBcAb-IgM 阳性率在重叠感染组中明显高于单纯 HBV 感染（P ＜0．05）。结论乙、丁型肝炎病毒重叠感染在慢性 HBV 中的发生率高。随着 HBV 病毒 DNA 数量的增加，肝功能的异常率也增高，HDV 感染能抑制 HBeAg 表达，重叠感染组中 HBcAb-IgM 阳性率高，可能与慢性乙型肝炎病情加重反复有关。
목적：통과비교단순을형간염병독（HBV）화을정형간염병독（HBV HDV）중첩감염적환자혈청중 ALT、HBV DNA급 HBV 혈청학표지（HBVM）등적이동，료해 HBV HDV 중첩감염특점，초보탐토 HDV 적치병궤리。방법대95례 HBV HDV 중첩감염적환자생물화학지표、간염병독표지물등작통계분석，이100례단순 HBV 감염환자작위대조。결과재95례중첩감염자중，만성을형간염발생솔최고，점66．32％，간경화차지。안 HBV DNA 재량분류，량자차이무통계학의의（P ＞0．05），중첩감염조 ALT 이상솔여 HBV DNA 정정상관（r ＝0．90，P ＜0．05）。중첩감염조이 HBeAg 음성모식위주（P ＜0．05），안HBsAg＞250 IU/mL 통계，차이무통계학의의（P ＞0．05）；안 HBsAg＞250 IU/mL 차 HBeAg ＞1 S/CO 통계시，단순 HBV 조고우중첩감염조（P ＜0．05）。HBcAb-IgM 양성솔재중첩감염조중명현고우단순 HBV 감염（P ＜0．05）。결론을、정형간염병독중첩감염재만성 HBV 중적발생솔고。수착 HBV 병독 DNA 수량적증가，간공능적이상솔야증고，HDV 감염능억제 HBeAg 표체，중첩감염조중 HBcAb-IgM 양성솔고，가능여만성을형간염병정가중반복유관。
Objective To understand the characteristics of the superinfection of hepatise B virus (HBV)together with hepatitis D virus(HDV)by comparing the differences of serum markers ALT,HBV DNA,HBVM,etc.In the pure HBV infection and the superinfection of HBV and HDV and to preliminarily invesitigate the pathogenesis of HDV.Methods The results of major bio-chemical indicators and hepatitis virus markers in 95 cases of HBV together with HDV infection and 100 cases of pure HBV infec-tion as the control group were statistically analyzed.Results Among 95 cases in the superinfection group,the incidence rate of chronic HBV was the highest,accounting for 66.32% and followed by liver cirrhosis.There was no statistical difference between the two groups according to the HBV DNA loads(P >0.05).The good positive correlation existed between the ALT abnormal rate of the liver function and HBV DNA in the superinfection group(r=0.90,P <0.05).The HBeAg negative mode was predominant in the superinfection group (P <0.05 ).There was no difference beween the two groups according to HBsAg > 250 IU/mL (P >0.05).According to HBsAg>250 IU/mL and HBeAg > 1 S/CO,the pure HBV infection group was higher than the super infec-tion group (P <0.05).The positive rate of HBcAb-IgM in the super infection group was significantly higher than that in the pure HBV group (P <0.05).Conclusion The superinfection of HBV together with HDV infection has the high occurrence rate in chro-nic hepatitis B.With the HBV DNA level increase,the abnormal rate of the liver function is also increased.HDV infection can inhib-it the HBeAg expression.The high positive rate of HBcAb-IgM in the superinfection patients might be related with chronic hepatitis B aggravation and recurrence.