儿童病毒性肝炎感染模式的临床研究.docVIP

???? 儿童病毒性肝炎感染模式的临床研究 ???? ????　［摘　要］　目的　探讨儿童病毒性肝炎临床感染模式及其对肝功能的影响。方法　对150例儿童病毒性肝炎临床资料进行分析并采用χ2检查和t检查对其进行统计学处理。结果　150例儿童病毒性肝炎，单一肝炎病毒感染占77.3%，病原有HAV，HBV，HCV及HEV，其构成分别为54.7%，18.0%，2.7%和2.0%。甲型肝炎(TAH)好发于7～12岁儿童，女性比率高于男性。乙型肝炎(TBH)好发于7～9岁年龄组，男性为主。二重感染占总数的10.7%，有HAV-HBV，HBV-HCV，HBV-HDV和HBV-HEV等模式，感染率分别为8.0%，0.7%，1.3%和0.7%。三重感染5例，为总数的3.3%；有HAV-HBV-HDV和HAV-HCV-HEV模式，前者3例，感染率为2%，后者2例为1.3%。重叠感染好发于7～9和10～12岁年龄段儿童，且男性多见。此外有8例各项病原学检测均为阴性，占5.3%。结论　儿童病毒性肝炎有单一和重叠感染模式，并有明显年龄与性别差异，肝功能改变与感染模式关系不大。　　［关　键　词］　病毒性肝炎；感染模式；儿童　　［中分类号］　R512.6　　［文献标识码］　A　　［文章编号］　1008-8830(2000)03-155-03 Infection Modes of Viral Hepatitis LIU Xiang-Guo（Department of Infectious Disease, Hunan Provincial Hospital, Changsha 410007） 　　［Abstract］　Objective　To study the infection modes of viral hepatitis in children and the relationship between the modes and liver function. Methods　One hundred and fifty cases of children with viral hepatitis were enrolled in this retrospective study. Results　Infection with a single hepatitis virus accounted for 77.3% of the cases (HAV (54.7%, HBV 18%, HCV 2.7% and HEV 2%). Infection involving two hepatits viruses accounted for 10.7% (HAV-HBV 8%, HBV-HCV 0.7%, HBV-HDV 1.3% and HBV-HEV 0.7%), and infection involving three hepatitis viruses occurred in 3.3% (HAV-HBV-HDV 2% and HAV-HCV-HEV 1.3%). Infection with more than one hepatits virus occurred more often in children aged 7～12 years; boys were more likely to have multiple infections than girls. There were no significant differences liver function tests in children with single and multiple viral infections. Conclusions　The risk for simultaneous infection with more than one hepatitis virus is influenced by a childs age and sex. Infection with multiple viruses does not appear to result in greater liver function damage than infection with a single hepatitis virus.　　［Key words］　Viral hepatits; Infection mode; Child 　　病毒性肝炎是由多种肝炎病毒引起的常见病，近年来国内外有关成人肝炎病毒重叠感染，重叠感染与慢性肝炎、重型肝炎的关系已有报道［1～3］，但儿童肝炎病毒重叠感染系统研究和文献报道甚少，本文从感染模式及其与临床之间的关系角度出发对1994年