114例重型病毒性肝炎的血清病原学分析

The serum etiology analysis for 114 cases of viral hepatitis gravis

目的 分析重型病毒性肝炎 (重肝 )的临床分型预后与病原学之间的关系。方法 应用酶联免疫吸附试验 (ELISA)、聚合酶链反应 (PCR)等检测方法对 114例重肝患者进行病原学分析。结果 114例重肝患者中 ,急性重肝 5例 (4.39% ) ,亚急性重肝 2 4例 (2 1.0 5 % ) ,慢性重肝 85例 (74 .5 6 % )。其中乙型病毒感染 88例 ,戊型病毒感染 31例 ,乙戊病毒重叠感染 16例 ,其他肝炎病毒感染 (包括甲、丙、丁型和未分型 ) 2 5例。重肝病死率高 ,本组病例重肝死亡 81例 (71.0 % ) ,重肝的死亡与病毒感染类型有密切关系 ,其中单纯乙肝病毒感染所致死亡占 5 3 0 9% ,其次为乙戊病毒感染重叠占 12 .35 % ,单纯戊肝病毒感染和未分型病毒感染分别占 11.11%。 2 2例老年重肝患者中 ,死亡 18例 (81.82 % )。结论 在引起重肝的肝炎病毒的单一或重叠感染中 ,乙肝和戊肝病毒感染所占比例较高。乙肝病毒是引起重肝的主要病原体。戊肝与乙肝病毒重叠感染也占很大比例应予重视。重肝的病死率高 ,尤其是老年性重肝。

ObjectiveTo analyze the relationship between clinical type,prognosis and etiology for viral hepatitis gravis(hepatitis gravis).MethodsUsing enzyme linked immunosorbent assay(ELISA),polymerase chain reaction(PCR) to detect and analyze the etiology for 114 cases of hepatitis gravis. Results5 cases(4.39%) of 114 cases of hepatitis gravis were acute hepatitis gravis. 24 cases(21.05%) were subacute hepatitis gravis. 85 cases(74.56%) were chronic hepatitis gravis. 88 cases with hepatitis gravis infected with HBV, 31 cases infected with HEV, 16 cases infected with super infection of HBV and HEV, 25 cases infected with another virus(including HAV?HCV?HDV and non A E virus). The mortality of the patients with hepatitis gravis was higher(71.0%) and related with etiology closely(HBV infection:53.09%, super infection of HBV and HEV:12.35%, HEV and non A E virus infection:11.11% respectively). The mortality of senile patients was 81.82%.Conclusion HBV and HEV were major pathogens, especial HBV. super infection of HBV and HEV was also important. The mortality of hepatitis gravis was higher, especial in senile patients.