急性病毒性肝炎患者54例临床分析

Clinical analysis on 54 cases with acute viral hepatitis

目的观察和分析急性病毒性肝炎(AVH)患者的临床特征。方法回顾性分析2012年1月至2013年3月本科室收治的54例AVH患者的临床资料及生物化学指标。结果 54例患者中,男性31例,女性23例,男女比例为1.35:1,平均年龄(43.85±15.95)岁。根据病原分布,分为急性乙型肝炎(AHB)组(29例,53.70%)、急性戊型肝炎(AHE)组(18例,33.33%)、未分型肝炎组(6例,11.11%)、乙型肝炎肝硬化基础上重叠戊型肝炎病毒感染组(1例,1.85%)。AHB组患者中有3例为妊娠期女性。AHB组[(37.76±13.67)岁]发病年龄低于AHE组[(54.11±13.97)岁],差异有显著统计学意义(P<0.01)。血清白蛋白(ALB)水平方面,AHB组[(37.24±3.68)g/L]患者较AHE组[(33.73±4.61)g/L]高,差异有显著统计学意义(P<0.01)。AHB、AHE两组患者的性别比、血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBil)、γ-谷氨酰转移酶(γ-GT)、碱性磷酸酶(AKP)、总胆汁酸(TBA)、胆碱酯酶(CHE)水平及住院时间,差异均无统计学意义(P均>0.05)。结论 AHB、AHE是目前常见的AVH类型,AVH预后良好。妊娠合并AHB需引起注意。AHB多见于中青年,AHE多见于中老年。AHB患者血清ALB水平高于AHE患者。

Objective To investigate and analyze clinical characteristics of patients with acute viral hepatitis. Methods Data of 54 cases with acute viral hepatitis in our department from January 2012 to March 2013 were analyzed by descriptive method. Results Among 54 cases with acute viral hepatitis, 31 cases were male and 23 cases were female, with the ratio of male/female as 1.35︰1, and the mean age was （43.85 ＆plusmn; 15.95） years old. The results showed that 29 （53.70%） cases were acute hepatitis B （AHB）, 18 （33.33%） cases with acute hepatitis E （AHE）, 6 （11.11%） cases with undifferentiated type hepatitis and 1 （1.85%） cases with AHE complicated with cirrhosis based on hepatitis B. There were 3 pregnant women in AHB group. The average age of onset of AHB [（37.76 ＆plusmn; 13.67） years old] was lower than that of AHE [（54.11 ＆plusmn; 13.97） years old], and the difference was statistically significant （P ＜ 0.01）. The level of albumin （ALB） of AHB [（37.24 ＆plusmn; 3.68） g/L] was higher than that of AHE [（33.73 ＆plusmn; 4.61） g/L]. The difference of ALB between the two groups was significant （P ＜ 0.01）. There were no significant difference in sex ratio and peak values of alanine aminotransferase （ALT）, aspartate amino transferase （AST）, total bilirubin （TBil）, ＆gamma;-glutamyltransferase （＆gamma;-GT）, alkaline phosphatase （AKP）, total bile acid （TBA） and cholinesterase （CHE） between AHB and AHE group （all P ＞ 0.05）. The difference of course of hospital stay between the two groups were not significant （P ＞ 0.05）. Conclusions AHB and AHE were the common types of AVH. The prognosis of AVH is favorable. We should pay more attention to pregnancy women who were complicated with AHB. AHB was more common in youngers and middle-aged, while AHE more common in the elders. And serum levels of ALB was higher for patients with AHB than AHE.