秦皇岛市各型肝炎病毒感染的血清流行病学研究

A seroepidemiological study of hepatitis viruses among the patients with different types of liver disease in Qinhuangdao

对１９９２年至１９９５年在秦皇岛市各医院住院的３２６例肝病患者进行各型肝炎病毒感染的血清流行病学分析，表明在慢性肝炎（ＣＨ）、肝硬化（ＬＣ）和原发性肝细胞肝癌（ＨＣＣ）中未检出甲型肝炎病毒抗体（抗－ＨＡＶＩｇＭ）。乙型肝炎病毒（ＨＢＶ）在ＣＨ、ＬＣ和ＨＣＣ的感染率分别为，７７７８％，８４２１％和９４２９％，而在急性肝炎（ＡＨ）中的感染率为２１５９％。丙型肝炎病毒（ＨＣＶ）的感染率为１０１２％，并随肝病患者年龄增长及慢性化程度而逐渐增高，在ＬＣ和ＨＣＣ中的感染率分别为１４７４％和２０００％，高出ＡＨ和ＣＨ的３９５倍，有非常显著性差异。在各种肝病中戌型肝炎病毒（ＨＥＶ）感染的阳性检出率为１３１９％，但未发现单纯感染引起ＣＨ、ＬＣ和ＨＣＣ本研究总的重叠感染率为１７１８％，ＡＨ、ＣＨ、ＬＣ和ＨＣＣ重叠感染率分别为１１６４％，１０１９％，２４２１％和２８５７％。相互间有显著性差异。ＡＨ以ＨＡＶ重叠ＨＥＶ、ＨＢＶ和ＨＣＶ为主。ＣＨ以ＨＢＶ重叠ＨＥＶ和ＨＣＶ为主。ＬＣ和ＨＣＣ以ＨＢＶ重叠ＨＣＶ和ＨＥＶ为主。ＨＢＶ＋ＨＣＶ和ＨＢＶ＋ＨＥＶ感染中，ＬＣ和ＨＣＣ非常显著高于ＡＨ和ＣＨ。重叠感染，特?

This article described a seroepidemiological surveillance in 326 patients with different clinical types of liver disease (acute hepatitis, AH; chronic hepatitis ,CH; liver cirrhosis , LC; hepatocellular carcinoma, HCC) from hospitals in Qinhuangdao city during 1992-1995. The results showed that HAV infection could not develop chronic hepatitis. Among 238 patients of CH、LC 、and HCC, anti-HAV IgM was not detected. HBV infection was the main pathogenic factor of CH, LC, and HCC with an infection rates of 77.78%, 84.21%,and 94,29%, respectively, the average rate of infection was 3.8 times higher than that in AH. HCV infection rate was increased gradually with development of chronic liver syndrome. Anti-HCV positive rate was 5.56% in CH, but 14.74% and 20.00% in LC and HCC respectively. HEV infection was found in patients with all types of liver disease with an average positive rate of 13.19%. It was not found that single HEV infection developed in CH, LC, and HCC. The average rate of super infection was 17.18% among all the patients , but the super infection rate in LC and HCC was 1.93 times higher than that in AH and CH. It seems that the super infection of HBV and HCV was the main factor for worsened liver symptoms and for developing LC and HCC.