戊型肝炎重叠乙型肝炎感染的临床特征分析

Characteristics of Chronic Hepatitis B Patients Superinfected with Hepatitis E Virus:A Clinical Study

目的分析戊型肝炎重叠乙型肝炎感染的临床特征。方法用酶联免疫吸附试验(ELISA)检测戊型肝炎重叠乙型肝炎组、单纯戊型肝炎组和单纯乙型肝炎的肝炎标志物,同时检测生化指标,比较临床症状和并发症。结果重叠组的死亡率、重型肝炎率及自发性腹膜炎率均高于乙型肝炎组和戊型肝炎组;重叠组临床症状和戊型肝炎组差异无统计学意义,但比乙型肝炎组严重;重叠组HBeAg阴性率与HBV DNA阳性率和乙型肝炎组比较差异有统计学意义;丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、血清总胆红质(TbiL)和白蛋白(ALB)重叠组和乙型肝炎组比较差异有统计学意义,重叠组和戊型肝炎组除TbiL外均差异不大。结论与单纯HBV和HEV感染比较,戊型肝炎重叠乙型肝炎感染临床症状和肝脏损害更严重,死亡率更高。

OBJECTIVE To investigate the clinical characteristics of chronic hepatitis B patients superinfected with hepatitis E virus. METHODS The hepatitis markers were detected by ELISA, the biochemical indicators were analyszd, and the clinical symptoms and complications were compared. RESULTS The rates of the mortality, severe hepatitis and spontaneous peritonitis in superinfection group were higher than those of HBV alone group and HEV alone group. The clinical symptoms in superinfection group were similar to HEV group, but more serious than HBV group. There was a statistical significance in negative rate of HbeAg and positive rate of HBV DNA between the HBV group and superinfection group, and the two groups also produced statistical significance in ALT, AST, TbiL, and ALB, but the difference between superinfection group and HEV group was not very different, except TbiL. CONCLUSION Compared to that of the HEV alone group and HBV alone group, the chronic hepatitis B patients superinfected with hepatitis E virus have more severe symptoms, and hepatic damage and higher mortality.