威宁县159例甲型病毒性肝炎患者临床特征及结局分析

Clinical features and outcomes of 159 cases of hepatitis A in Weining County

目的观察临床型甲型病毒性肝炎（甲肝）患者的临床特征及救治规律。方法回顾性收集159例甲肝患者临床资料，按年龄段进行分组，所有患者给予支持、对症、保肝和退黄治疗，观察消化道症状、体征、ALT、TB、PT及肝功能复常时间。结果纳人观察患者在男女比上接近1：1（83／76），以儿童和青少年感染为主（76．73％）。主要临床症状和体征是：乏力、纳差、尿黄、皮肤巩膜黄染。所有患者在治疗后均获得痊愈，成人组在肝功能复常时间上长于儿童组和青少年组[（32．21±8．846）天vs．（20．92±9．584）天VS．（25．00±11．743）天1。结论临床型甲肝呈急性自限性经过，通过治疗能获得很好临床结局。部分地区低龄人群因特异性免疫力低，可能成为暴发流行的易感人群。

Objective To observe clinical features and unified treatment of apparent infection group of hepatitis A. Methods Data of 159 cases of hepatitis A, including digestive tract symptom, signs, alanine aminotransferase （ALT）, total bilirubin （TB）, prothrombin time （PT） and recovery time of liver function were collected. 159 patients were divided into three groups according to age, all received supportive treatment, symptomatic treatment, liver protection, removing jaundice. Results The gender ratio was approximately 1：1 （83/76）, children and teenagers were major victims （76.73%）. The main symptoms and signs were fatigue, anorexia, urine bilirubin, skin and sclera jaundice. The recovery time of liver function of adults was longer than those of children and teenagers [（32.21 ＋ 8.846）d vs.（20.92 ＋ 9.584）d vs.（25.00 ＋ 11.743）d]. Conclusions Apparent infection group of hepatitis A was a self-limited disease with a good clinical outcome. The younger group has a lower specific immunity in several villages, who could be susceptible population in epidemic outbreak.