散发性戊型肝炎148例临床分析

Clinical Analysis of 148 Cases of Sporadic Hepatitis E

[目的]分析散发性戊型肝炎的临床特点.[方法]回顾性分析148例散发性戊型肝炎患者的临床资料,按照年龄分为非老年组（〈60岁）与老年组（≥60岁）,按照病原学分为单纯感染组与重叠感染组,比较各组之间的差异.[结果]148例患者男女比例1.55∶1,30～59岁91例（61.4= 8.01,P＜0.01）.老年组白蛋白（ALB）水平明显低于非老年组（t=4.26,P＜0.01）,总胆红素（TBIL）水平、凝血酶原时间（PT）明显高于非老年组（t1=2.02,t2=2.51,P＜0.05）.重叠感染组重型肝炎的比例明显高于单纯感染组（χ2=8.27,P＜0.01）.重叠感染组TBIL、PT明显高于单纯感染组（t1=2.41,t2=2.20,P＜0.05）.老年组住院时间较非老年组明显延长（t=4.18,P＜0.01）.3例死亡病例为老年组和重叠感染组患者.[结论]散发性戊型肝炎以中青年男性多发,有冬春季发病高峰,大多数患者预后良好。

[Objective] To analyze the clinical features of sporadic hepatitis E（HE）. [Methods] Clinicaldata of 148 patients with sporadic HE were analyzed retrospectively. According to the age, all patients were divided into non-aged and aged group. According to the etiology, the patients were divided into simple infection and superinfection group. The differences among these groups were compared. [Results] Of the 148 cases, the ratio of male to female was 1.55 ： 1. There were 91 patients（61.4%） aged 30-59 years. The season of the onset of 72 patients（48.6%） was January to April. The proportion of severe hepatitis in the aged group was significantly higher than that in the non-aged group（X^2 = 8.01, P 〈0.01）. The level of serum albumin （ALB） in the aged group was significantly lower than that in the non-aged group（ t = 4. 26, P 〈0. 01）, whereas the levels of serum total bilirubin（TBIL） and prothrombin time（PT） in the aged group were significantly higher than those in the non-aged group（t1= 2.02, t2 = 2.51, P〈0.05）. The proportion of severe hepatitis in the superinfection group was significantly higher than that in the simple infection group（X^2= 8.27, P 〈0.01）. The levels of serum TBIL and PT in the superinfection group were significantly higher than those in the simple infection group（t1 = 2.41, t2 = 2.20, P 〈0.05）. The hospital day in the aged group was significantly longer than that in the non-aged group（ t =4.18, P〈0.01）. There were 3 death cases of HE in the aged and superinfection group. [Conclusion] Sporadic HE mostly occurs in middle-aged males. It has a peak incidence in winter and spring. Most patients with HE have a good prognosis. Age and superinfection are the main factors that affect the prognosis.