[1]谭顺,谭文婷,刘明,等.176例甲型肝炎临床特征分析[J].陆军军医大学学报(原第三军医大学学报),2010,32(22):2409-2412.
 Tan Shun,Tan Wenting,Liu Ming,et al.Clinical characteristics of hepatitis A: report of 176 cases[J].J Amry Med Univ (J Third Mil Med Univ),2010,32(22):2409-2412.
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176例甲型肝炎临床特征分析(/HTML )
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陆军军医大学学报(原第三军医大学学报)[ISSN:1000-5404/CN:51-1095/R]

卷:
32卷
期数:
2010年第22期
页码:
2409-2412
栏目:
论著
出版日期:
2010-11-30

文章信息/Info

Title:
Clinical characteristics of hepatitis A: report of 176 cases
作者:
谭顺谭文婷刘明毛青邓国宏
第三军医大学西南医院全军感染病研究所
Author(s):
Tan Shun Tan Wenting Liu Ming Mao Qing Deng Guohong
Institution of Infectious Diseases, Southwest Hospital, Third Military University, Chongqing, 400038, China
关键词:
甲型肝炎慢性乙型肝炎重叠感染
Keywords:
hepatitis A chronic hepatitis B super-infection
分类号:
R447;R512.6
文献标志码:
A
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、年龄有统计学差异(P<0.05);重叠组ALT 5~10 ULN、TBIL>10ULN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,P<0.05),而单纯组ALT>10ULN、TBIL 5~10ULN比率显著高于重叠组(χ2值分别为6.903、5.033,P<0.05)。重叠组中,HBeAg-与HBeAg+患者比例为2.1︰1,HBeAg-患者占67.4%;HBV DNA≥104拷贝/ml与HBV DNA<104拷贝/ml患者比例为1.8∶1,HBV DNA<104拷贝/ml患者约占34.8%;HBeAg-与HBeAg+、HBV DNA≥104拷贝/ml与HBV DNA<104拷贝/ml分类比率均无统计学差异(P>0.05)。   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。
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 who admitted in our institute from April 2004 to December 2009. There were 59 cases positive to anti-HAV IgM and 92 cases positive to anti-HAV IgM and HBsAg. The hepatitis functions, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and direct bilirubin (DBIL) were measured. And the differences of hepatitis A in non-HBV carriers and in HBV carriers were compared. Upper limit of normal (ULN) of ALT and TBIL was used to categorize the patients.    Results   Incidence of hepatitis A were common in adults. The ratio of male to female was 2.4∶1. Hepatitis A in HBV carriers accouted for 52.3% (92/187), and the other 25 hepatitis A patients were accompanied with hepatitis C, D, E, Epstein-Barr virus infection, autoimmune/alcoholic hepatitis, or intrahepatic cholestasis of pregnancy. There were more ATL  5 to 10ULN, TBIL >10ULN, and severe hepatitis in HBV carriers than in non-HBV carrier (Chi square=8.127, 4.159, 6.999, P<0.05). More ALT>10ULN and TBIL 5 to 10ULN were found in non-HBV carrier than in HBV carriers (Chi square=6.903, 5.033, P<0.05). In HBV carrier, the ratio of HBeAg negative to positive was 2.1∶1, with former accounting for 67.4%, and the ratio of HBV- DNA≥104 to HBV DNA<104 was 1.8∶1, with the later accouting for 34.8%. The categorization with HBeAg and HBV DNA amount had no significant difference (P>0.05).    Conclusion   The hepatitis A in HBV carriers are more common than hepatitis A in non non-HBV carriers. Hepatitis A in HBV carriers may cause a heavier liver injury and easier to develop into severe hepatitis than that in non-HBV carriers.

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更新日期/Last Update: 2010-11-26