儿童病毒性肝炎感染模式的临床研究

Infection Modes of Viral Hepatitis

目的 探讨儿童病毒性肝炎临床感染模式及其对肝功能的影响。方法 对 15 0例儿童病毒性肝炎临床资料进行分析并采用 χ2 检查和t检查对其进行统计学处理。结果 15 0例儿童病毒性肝炎 ,单一肝炎病毒感染占 77.3% ,病原有HAV ,HBV ,HCV及HEV ,其构成分别为 5 4.7% ,18.0 % ,2 .7%和 2 .0 %。甲型肝炎 (TAH)好发于 7～ 12岁儿童 ,女性比率高于男性。乙型肝炎 (TBH)好发于 7～ 9岁年龄组 ,男性为主。二重感染占总数的10 .7% ,有HAV -HBV ,HBV -HCV ,HBV -HDV和HBV -HEV等模式 ,感染率分别为 8.0 % ,0 .7% ,1.3%和0 .7%。三重感染 5例 ,为总数的 3.3% ;有HAV -HBV -HDV和HAV -HCV -HEV模式 ,前者 3例 ,感染率为2 % ,后者 2例为 1.3%。重叠感染好发于 7～ 9和 10～ 12岁年龄段儿童 ,且男性多见。此外有 8例各项病原学检测均为阴性 ,占 5 .3%。结论 儿童病毒性肝炎有单一和重叠感染模式 ,并有明显年龄与性别差异 ,肝功能改变与感染模式关系不大。

Objective To study the infection modes of viral hepatitis in children and the relationship between the modes and liver function. Methods One hundred and fifty cases of children with viral hepatitis were enrolled in this retrospective study. Results Infection with a single hepatitis virus accounted for 77.3% of the cases (HAV ( 54.7% , HBV 18%, HCV 2.7% and HEV 2%). Infection involving two hepatits viruses accounted for 10.7% (HAV-HBV 8%, HBV-HCV 0.7% , HBV-HDV 1.3% and HBV-HEV 0.7% ), and infection involving three hepatitis viruses occurred in 3.3% (HAV-HBV-HDV 2% and HAV-HCV-HEV 1.3% ). Infection with more than one hepatits virus occurred more often in children aged 7～12 years; boys were more likely to have multiple infections than girls. There were no significant differences liver function tests in children with single and multiple viral infections. Conclusions The risk for simultaneous infection with more than one hepatitis virus is influenced by a child's age and sex. Infection with multiple viruses does not appear to result in greater liver function damage than infection with a single hepatitis virus. [