HBV共感染对不同类型肝包虫患者肝脏功能的影响

Effects of HBV co-infection on liver function of patients with different types of hepatic echinococcosis

目的分析乙型肝炎病毒(HBV)共感染对不同类型肝包虫病患者肝脏功能的影响。方法收集我国西部地区医院2014年至2015年期间确诊为肝包虫病的患者409例,抽取静脉血检测所有患者的肝功能指标;采用ELISA方法进行HBV表面抗原血清阳性测试;卡方检验明确HBV共感染在不同类型肝包虫病中的流行情况。以是否感染HBV为标准分组,以不同类型肝包虫病分层,对比HBV病毒共感染对不同类型肝包虫病患者肝脏功能的影响。结果肝包虫病患者共感染HBV后出现转氨酶升高、白蛋白降低等更为严重的肝脏功能损伤。与囊型肝包虫病患者相比,以多房棘球绦虫为病原体的泡型肝包虫病患者发生HBV病毒共感染的机会更高(38.4%vs.86.4%),差异具有统计学意义(P<0.05)。分层分析结果显示,以细粒棘球绦虫为病原体的囊型肝包虫病患者共感染HBV比无HBV共感染者肝脏功能损伤无统计学意义;但是以多房棘球绦虫为病原体的泡型肝包虫病共感染HBV患者较之无HBV共感染者表现出更为严重的肝脏损伤,肝功能指标显著下降(P均<0.05)。结论泡型肝包虫病患者更容易出现HBV病毒共感染,并且会导致更严重的肝脏损伤,在临床治疗中需要特别重视。

Objective To clarify the effects of HBV co-infection on liver function of patients with different types of hepatic echinococcosis. Methods We recruited 409 patients diagnosed with hepatic echinococcosis at three hospitals in western regions in China from 2014 to 2015. Venous blood was withdrawn to detect to liver function indications. ELISA was performed to detect HBsAg. We analyzed liver function in patients stratified by different types of hepatic echinococcosis with or without HBV infection. Resu[ts The hepatic echinococcosis patients infected with HBV had more severe impairment in liver functions such as reduced albumin and increased transaminase. The patients with hepatic alveolar echinococcosis were more vulnerable to HBV infection compared with those with hepatic cystic echinococcosis （38.4% vs. 86.4%, P〈0.05）. In addition, liver injury was more severe in patients diagnosed with alveolar hepatic echinococcosis and HBV infection compared with those diagnosed with cystic hepatic echinococcosis and HBV infection （all P〈0.05）. Conclusion Hepatic alveolar echinococcosis patients co-infected with HBV have worse liver injury compared with those hepatic cystic echinococcosis ones co-infected with HBV. Therefore, they deserve special attention in clinical treatment.