乙型肝炎及其与戊型肝炎重叠感染临床对照

目的了解乙型肝炎患者重叠戊型肝炎感染状况及重叠感染对病情的影响. 方法对单纯HBV感染者与HBV重叠HEV感染者进行临床对照研究.结果 726例乙型肝炎患者血清抗-HEV阳性率为12.25%(89/726).其中重型肝炎、肝硬化患者中抗-HEV阳性率分别为22.41%和18.83%;急性肝炎和慢性肝炎分别为8.69%和7.24%.重型肝炎、肝硬化患者抗HEV阳性率高于急性肝炎和慢性肝炎(P<0.01).各型肝炎重叠感染戊型肝炎后其肝功能恢复正常时间延长(P<0.05),且在乙型肝炎基础上重型肝炎和肝硬化重叠感染戊型肝炎血清胆红素明显升高(P<0.01).重叠感染者并发症及病死率较单纯感染者高. 结论乙型肝炎重叠感染戊型肝炎是病情加重及重症化的因素之一.

Clinical control study of superinfection of HBV and HEV

Objective To study the situation in patients of hepatitis B coinciding with HEV and to explore its influence on disease in patients with superinfection of HBV and HEV. Methods 726 hepatitis B patients were tested for serum anti-HEV and markers of HBV.A case control study of superinfection of HBV and HEV was carried out. Results Of the 726 patients, anti-HEV positive rate was 12.25%, the positive rate of anti-HEV in patients of severe hepatitis, cirrhosis, acute hepatitis, chronic hepatitis was 22.41%, 18.83%, 8.69% and 7.24% respectively. Markedly different anti-HEV positive rates(P<0.01) in patients of different clinical stages were found. After superinfection of HBV and HEV, the recovery time of liver function of hepatitis B prolonged significantly. The serum bilirubin concentration was higher than that in patients with acute hepatitis and chronic hepatitis(P<0.01). The rates of complication and mortality were higher than those in HBV. Conclusion HBV coinciding with HEV is one of factors of the deterioration of the disease.