老年急性和亚急性肝炎病因及预后关系的研究

Relationship between causes and prognosis of old patients with acute and subacute hepatitis

目的讨论老年急性和亚急性肝炎病因和预后的关系。方法回顾性分析2002～2010年本院收治的518例老年急性及亚急性肝炎患者的诊断及预后,分析老年急性及亚急性肝炎的病因及预后特点。结果老年急性及亚急性肝炎中,戊型肝炎发病率最高(61.2%);其次为乙型肝炎病毒感染(16.4%);病因不明的感染(12.9%)位居第3位。各种类型急性肝炎中,急性药物性肝炎病死率为36.84%,戊型肝炎的病死率为1.26%,乙型肝炎的病死率为2.35%。药物性肝炎发生重型肝炎的比例最高,为63.15%,戊型和乙型肝炎病毒感染发展为重型肝炎的比例分别为10%和10.81%,发展为重型肝炎后,病死率均显著增加。结论老年急性及亚急性肝炎的病因中,戊型肝炎病毒感染为主要感染因素。急性肝炎发展为重型肝炎后,病死率明显提高。药物性肝炎发展为重型肝炎的比例高、预后差,应引起重视。

Objective To investigate the relationship between causes and prognosis of old patients with acute and subaeute hepatitis. Methods Clinical analysis were carried out on 518 old patients with acute and subacute hepatitis who were admitted to our hospital from 2002 to 2010, retrospectively. Results The causes at the first two places of the old patients with acute and subacute hepatitis were HEV and HBV infection, with the respective incidence rate as 61. 2% and 16. 4%. Total of 12. 9% patients were agnogenic, at the third places. Among all cases, patients with acute drug hepatitis had a mortality rate of 36.84%. The mortality rate were 1.26% and 2.35% in patients with HEV and HBV infection. There were no dead eases in patients with HAV or HCV infection. The rate of patients with acute drug hepatitis developing into severe hepatitis was 63.15% , which were 10% and 10.81% in patients with HEV and HBV infection, respectively. Conclusions HEV infection was the most important causes in old patients with acute and subacute hepatitis. The mortality rate of patients significantly rised after developing into severe hepatitis. There was a high proportion of drug hepatitis progression to severe hepatitis and with poor prognosis, which should be paid more attention.