176例甲型肝炎临床特征分析.docVIP

176例甲型肝炎临床特征分析 谭 顺，谭文婷，刘 明，毛 青，邓国宏 （400038 重庆，第三军医大学西南医院全军感染病研究所） [摘要] 目的 了解我院收治甲型肝炎患者的临床特征，比较单纯甲型肝炎与甲型和乙型重叠感染的异同。 方法 对176例甲型肝炎患者流行病学资料进行回顾性分析。，分别比较单纯甲型肝炎与甲型和乙型重叠感染时的生化学指标、ALT和TBIL分类比率及重型肝炎比率的差异。 结果 甲型肝炎发病以青壮年为主，男女比例为2.4∶1，甲型和乙型重叠感染占52.3%。单纯甲型肝炎与甲型和乙型重叠感染的男女比例、年龄有显著性差异统计学差异（χ2=12.545，P0.01）；年龄也有显著性差异（P0.05）；重叠组ALT 5~10ULN、TBIL10ULN比率及重型肝炎比率均显著高于单纯组（χ2 值分别为8.127、4.159、6.999，P0.05），而单纯组ALT10ULN、TBIL5~10ULN比率显著高于重叠组（χ2值分别为6.903、5.033，P0.05）。重叠组中，HBeAg-与HBeAg+患者比例为2.1︰1 ,HBeAg-患者占67.4%；HBV- DNA≥104与HBV DNA104患者比例为1.8∶1，HBV- DNA104患者约占34.8%；HBeAg-与HBeAg+、HBV- DNA≥104与HBV DNA104分类比率均无统计学差异(P0.05)ALT、TBIL分类及重型肝炎比率均有显著性差异（χ2=10.304,7.709,6.999,P0.05）。 结论 甲型肝炎发病重叠感染患者更多见，甲型和乙型重叠感染时较单纯甲型肝炎肝功能损伤更重，更容易发生重型肝炎。 [关键词] 甲型肝炎；慢性乙型肝炎；重叠感染 [中图法分类号] [文献标志码] A Clinical characteristics of 176 cases with Hepatitis A Tan Shun, Tan Wenting, Liu Ming, Mao Qing, Deng Guohong (Institution of Infectious Diseases, Southwest Hospital, Third Military University, Chongqing 400038, China [Abstract] Objective To investigate the incidence of hepatitis A and the differences between hepatitis A in non-HBV carriers and in HBV carriers. Methods The clinical characteristics of 176 cases with hepatitis A were analyzed. The hepatitis function and the rate of hepatitis A in non-HBV carriers and in HBV carriers were compared. Results Incidence of hepatitis A were common in adults. The ratio of male to female was 2.4:1; Hepatitis A in HBV carriers takes the rate of 52.3.There were significantly differences in gender（χ2=12.545，P0.01）, age（P0.05）, ALT( χ2=12.545，P0.01), TBIL（χ2=12.545，P0.01）and the severe hepatitis（χ2=12.545，P0.01）between hepatitis A in non- HBV carriers and hepatitis A in HBV carriers. Conclusion The hepatitis A in HBV carriers had a mainly composition in the incidence of hepatitis A . Hepatitis A in HBV carriers could cause a heavier liver injury and easier to develop into severe hepatitis than non-HBV carriers. [Key words] hepatitis A; ch