HDV感染后乙型肝炎患者血清肝炎病毒标志物的变化

The prevalence of serum viral hepatitis markers in patients with hepatitis D virus infection

目的 分析HDV感染患者血清病毒性肝炎标志物的变化和意义 ,探讨HDV致病机理。方法 对 469例HDV阳性乙型肝炎患者常见各类型病毒性肝炎血清标志物的变化等作统计分析 ,以 2 13例HDV( -)乙型肝炎患者作对照。结果 HDV感染后血清HBeAg检出率降低 (P <0 .0 1)。在HDV ( +)HBVDNA( -)组 ,HBeAg( -)的机会大 (P <0 .0 1)。在急性肝炎、重型肝炎和肝硬化患者HDAg( +)HBeAg( -)为主要血清病毒表现形式 (P <0 .0 1或 0 .0 5 )。HDV感染后合并其它肝炎病毒感染率高于乙型肝炎组。结论 HDV感染可抑制HBV复制或HBeAg表达 ,混合感染HDV的乙型肝炎中HDV的直接细胞毒性作用可能起主要致病作用。重叠感染HDV的乙型肝炎患者其病情重、病死率高和容易慢性化。

Objective To explore the pathogenesis of hepatitis D virus.Methods The serum hepatitis virus markers in 469 patients with hepatitis B and hepatitis D coinfection were analyzed,and compared with 213 cases of hepatitis B.Results The detection rate of HBeAg in serum of patients with HDV(+)was obviously lower than that of the patients with HDV(-)( P<0.01 ).Expression of HDAg(+)/HBeAg(-)in HBV DNA(-) group was higer than that of HBV DNA(+)group( P<0.01 ).But in acute hepatitis,severe hepatitis and liver cirrhosis,the expression of HDAg(+)/HBeAg(-)were obviously higher than that of HDAg(+)/HBeAg(+).The patients with HDV infection was easily coinfected with other hepatitis virus.Conclusion HDV infection can inhibit the replication of HBV.The effects of directly cytotoxic to hepatocytes of HDV may play an major pathogenic role in acute hepatitis D and in aggravating illness status to severe type.