TTV阳性肝病患者的临床与病理学特征初步观察

Preliminary observation on clinical manifestation and hepatopathology in patients with TTV-positive hepatitis

目的观察TTV阳性肝病患者的临床和病理特征。方法用巢式PCR法检测TTV-DNA,同时观察血清生化指标,肝组织活检观察其病理变化。结果 TTV感染者的血清学模式以重叠HBV、HCV、HAV、HEV、HGV二重感染为主占57. 9％(22/38)。以乏力、纳差、腹胀为临床特征,TBiL、ALT变化不明显。TTV单独感染者为42. 1％(16/38),急性发病者临床特征多与“急性黄疸性肝炎”相似。病理改变与各型病毒性肝炎的病理变化基本相似,但主要以肝门脉区炎症,小叶间胆管损伤,灶状坏死为多见。结论 TTV可与各型已知肝炎病毒重叠感染也可单独感染。

Objective To observe the clinical manifestation and hepatopathology in patients with transfusion transmitted virus (TTV)-positive hepatitis. Methods In 38 patients with TTV-positive hepatitis, TTV DNA was examined by st PCR. Parameters representing liver functions including serum bilirubin, ALT, albumin and globulin were measured, liver biopsy performed to investigate the hepatopathological features. Results TTV-positive patients co-infected with HBV, HCV, HAV, HEV or HGV accounted for 57.9% (22/38). They exhibited such cinical manifestations as lassitude, anorexia and abdominal distension etc. Changes of the levels of serum bilirubin and ALT in them were not remarkable. The patients infected with only TTV accounted for 42.1 % . Of the patients, the ones with acute onset of illness exhibited clinical features similar to those in patients with acute icteric hepatitis. The hepatopathological changes were similar to those of various types of viral hepatitis. However, they mainly presented as portal tract inflammation, damage of the interlobular bile duct and focal necrosis. Conclusion TTV can be either co-infected with, various types of hepatitis viruses or infected independently.