一种新型肠传性病毒性肝炎的临床流行病学及病毒学的初步研究

AN OUTBREAK OF ENTERIC TRANSMITTED NON-A,NON-E VIRAL HEPATITIS,PRIMARY STUDY OF CLINICAL EPIDEMIOLOGY AND VIROLOGY

目的阐明长期单项血清转氨酶增高为主要特征的肝损害病人的病因、传播和病变。方法对381例病人行流行病学调查、临床观察、肝活组织检查以及血清和粪便的聚合酶链反应检测。结果根据临床和检测结果可排除中毒引起,已知肝炎病毒的血清标志物均阴性。症状轻微,病程多呈急性,少数可超过6个月。肝组织呈汇管区炎。散在发病后进行3次人群普查,3个月累计发病率占流行人群的60.7%。由病人的急性期血清和潜伏期粪便提取DNA,检出与一种新近报告的输血传播性病毒(TTV)有同源性的基因片段。结论可能是另一种肠道传播型肝炎病毒引起的非甲非戊型病毒性肝炎。

Objective To investigate an outbreak of patients with serum transaminase elevation,in order to define the disorder and the possible etiology.Methods Epidemiological investigation,clinical observation,liver biopsy and virology study.Results The major feature was transaminase elevated,but all serum markers of known viral hepatitis were negative.The symptoms were mild and self-limited, whereas a few patients had a prolonged and relapsed course,Histology revealed mild portal hepatitis or only reactive inflammation.The disease has already appeared since 1994,and outbreak developed since October 1996.Totally,381 cases occurred and the case rate was as high as 60.7%.The daily-life contact and small scale food transmission were considered.The epidemic has been under control for 2 months after prevention measures for gastroenteric infection were taken.Conclusion The disorder might be non- A,non-E,but another type of enteric transmitted viral hepatitis.