188例散发性急性戊型肝炎临床分析

Clinical Analysis of 188 Cases With Sporadic Acute Hepatitis E

目的:总结散发性急性戊型肝炎(AHE)的临床特征。方法:回顾性分析188例急性戊型肝炎患者的临床资料。结果:188例散发性急性戊型肝炎以男性患者(83%)多见。临床表现以黄疸(81.9%)、乏力(70.2%)、纳差(64.4%)和腹胀(24.5%)最为常见。男性黄疸发生率和总胆红素(TBil)峰值均显著高于女性(P均<0.01)。老年组(≥60岁)γ-谷氨酰转移酶(GGT)峰值、凝血酶原活动度(PTA)最低值、胆碱酯酶(CHE)最低值和血清白蛋白(ALB)最低值均显著低于非老年组(<60岁)(P均<0.05)。老年组重型AHE发生率和死亡率均高于非老年组(P均<0.01)。结论:散发性AHE以男性多见,老年组患者可能由于其肝脏储备功能差而导致重型AHE发病率和死亡率高于非老年组患者。

Objective： To analyze the clinical features of sporadic acute hepatitis E （AHE）. Methods： Clinical data of 188 cases with sporadic AHE were analyzed retrospectively. Results： The incidence of AHE was more common in men （83%）. The common symptoms included jaundice （81.9%）, fatigue （70. 2%）, anorexia （64. 4%） and abdominal distention （24. 5%）. The incidence of jaundice and peak value of total bilirubin in men is significantly higher than those in women （P〈0. 01）. The peak value of T-glutamyltransferase （GGT）, minimum value of prothrombin activity （PTA）, cholinesterase （CHE） and albumin （ALB） were significantly lower in the aged group （≥ 60 years old） than those in non-aged group （P〈0. 05）. The incidences of severe AHE and mortality in aged group were higher than those in non-aged group （P〈0. 01）. Conclusions： Sporadic AHE are mostly seen in men. The poor reserve function of the liver may be responsible for the higher incidence of AHE and mortality in patients over 60-year-old.