戊型病毒性肝炎相关性再生障碍性贫血3例及文献复习

3 cases of hepatitis associated aplastic anemia caused by acute hepatitis E

通过回顾性分析2000年1月-2013年5月收入北京地坛医院的3例戊型病毒性肝炎相关性再生障碍性贫血患者的临床资料、临床特点及诊治情况探讨戊型病毒性肝炎相关性再生障碍性贫血(HAAA)患者的临床特点及诊治方法。结果显示3例患者均在肝炎恢复期感染戊肝病毒,进展迅速,因重度贫血进而行骨髓穿刺活检明确诊断,2例患者经积极对症治疗后,病情明显缓解,1例患者因个人原因拒绝丙球等再障的特效治疗,最终合并多重感染死亡。HAAA无明显前驱症状,且常发生在肝炎的恢复期,故对肝炎病毒原因未明的年轻男性患者,需监测血常规,必要时行骨髓穿刺,及早发现HAAA,最大程度降低该病死亡率。

The clinical features and the outcomes of diagnosis and treatment of 3 patients with HAAA, who were admitted to hospital from Jan. 2000 to May. 2013 were analyzed retrospectively. They were infected with hepatitis E virus in hepatitis eonvaleseenee. They were con- firmed the diagnosis by bone marrow biopsy due to severe anemia. Two patients were cured. One patient was died because refusing gamma- globulin for personal reasons. HAAA was no prodromal symptoms, which occurred in hepatitis recovery, so the young male patients with hep- atitis virus of unknown cause were needed to monitor blood and bone marrow biopsy.