庚型病毒性肝炎22例临床观察(附7例病理报告)

Clinical observation of 22 patients with hepatitis G (including histopathological data of 7 cases)

目的：观察庚型肝炎（ Ｈ Ｇ）临床、生化和病理特点。方法：用逆转录聚合酶链反应（ Ｒ Ｔ Ｐ Ｃ Ｒ）检测血清 Ｈ Ｇ Ｖ Ｒ Ｎ Ａ，并对２２ 例 Ｈ Ｇ的临床表现、肝功能检查和７ 例肝组织的病理特征进行分析。结果：（１） Ｈ Ｇ 的传播以输血及血制品和注射途径为主；（２）７ 例单纯 Ｈ Ｇ 的临床表现有一定隐匿性，血清丙氨酸转氨酶（ Ａ Ｌ Ｔ）、总胆红素（ Ｔｂｉｌ）、白蛋白（ Ａ）、 Ａ／ Ｇ、和凝血酶原活动度（ Ｐ Ｔ Ａ）的异常程度均明显轻于 Ｈ Ｇ重叠慢丙肝（９ 例）或慢乙肝者（６ 例）（ Ｐ＜ ０．０５）；（３）肝组织学示３ 例单纯 Ｈ Ｇ者呈急性轻型肝炎改变，而４ 例 Ｈ Ｇ 合并慢丙肝或慢乙肝者的肝组织则呈现不同程度的炎症活动和肝纤维化。结论：单纯 Ｈ Ｇ Ｖ 感染的临床症状和肝损害均较轻、预后良好，而 Ｈ Ｇ重叠慢性乙肝或慢性丙肝者则肝功能损害可较明显。

Objective:To study the clinical feature,liver function tests and histopathology of hepatitis G virus(HGV)infection.Methods:HGV RNA in sera from 22 patients with hepatitis G were detected by RT PCR.The transmission route,clinical manifestation and liver function tests were analyzed in all patients,and liver histological changes were studied in 7 out of them.Results:Transfusion,blood products and injection were dominating over the spread of HGV.Seven patients infected alone by HGV including 3 cases of underwent liver biospy showed mild symptoms and liver slight damage,while 4 patients with HG superinfected by HCV or HBV showed more or less necroinflammatory activity and fibrosis.Furthermore,the abnormal degree of the serum alanine aminotrasferase(ALT),total bilirubin(TBIL),albumin(A),A/G and prothrombin activity(PTA)were more light in 7 patients infected alone by HGV than that in 15 cases of HG accompanied with chronic hepatitis C or chronic hepatitis B( P <0.05).Conclusion:HGV alone infection may cause mild acute hepatitis and have a good prognosis,while HGV supreinfection with HCV or HBV may result in obvious liver damage.