戊型肝炎胆汁淤积患者的临床特征分析

Clinical character analysis of patients with cholestatic hepatitis E

[目的]研究分析戊型肝炎胆汁淤积患者的临床特征。[方法]回顾性分析2011-01—2014-12于北京市地坛医院住院的110例戊型肝炎胆汁淤积患者的病例资料,从年龄、性别、既往史、并发症、检查指标、转归等方面进行研究。[结果](1)共纳入110例戊肝胆汁淤积患者,其中男95例(86.36%),女15例(13.64%)。(2)平均年龄55.85岁,其中男56.36岁,女52.67岁。(3)平均住院时间为29.76d。(4)61例患者既往无肝病病史,26例有长期大量饮酒史。21例重叠其他嗜肝病毒感染,合并肝硬化患者14例。(5)临床症状方面,58例(52.73%)患者病程中出现皮肤瘙痒或灰白便,伴皮肤瘙痒患者的住院时间为(33.42±10.81)d,多于无皮肤瘙痒患者的(27.23±8.97)d,差异有统计学意义(P<0.05)。(6)患者总胆汁酸(TBA)的高峰出现时间[第(16.26±10.00)天]要早于总胆红素(TBIL)[第(18.64±9.26)天]、碱性磷酸酶(CALP)[第(19.06±12.20)天]和谷氨酰基转移酶(GGT)[第(20.76±13.83)天]。(7)并发症方面,有22例(20.00%)出现腹水,19例(17.27%)出现低蛋白血症,胆系感染与腹腔感染者各8例(7.27%)。(8)转归方面,104例(94.55%)患者临床痊愈或好转,6例(5.45%)自动出院,无死亡病例。[结论](1)戊型肝炎胆汁淤积患者主要为男性,多数患者年龄超过50岁;(2)过半患者出现了胆汁淤积的典型症状(皮肤瘙痒及灰白便),伴有皮肤瘙痒的患者住院时间长于不伴有皮肤瘙痒的患者;(3)在反映戊型肝炎胆汁淤积的病情进展方面,TBA要早于TBIL、ALP、GGT等指标。

[Objective]To comprehend the clinical characteristics of cholestatic hepatitis E.[Methods]This article summarizes retrospectively the clinical characteristics of 110 patients hospitalized in Beijing Ditan hospital due to cholestatic hepatitis E during the recent 4 years;They were analyzed from the aspects of age,gender,past history,complications,laboratory indicators and prognosis.[Results]Clinical characteristic：（1）Among these patients,86.36% were of male and 13.64% were female.（2）The overal average age was55.85.（3）The average stay days in hospital was 29.76 days.（4）61 of them were pure hepatitis E patients,26 had drunk heavily,21 had infected other hepatotropic virus and 14 had suffered cirrhosis.（5）About 52.73%of these patients had decolorized stool or skin ichiness.The average hospitalized days of pruritus group was（33.42±10.81）days,which was more than（27.23±8.97）days of non-pruritus group（P〈0.05）.（6）The peak of serum TBA（16.26±10.00）days appeared earlier than TBIL（18.64±9.26）days,ALP（19.06±12.20）days and GGT（20.76±13.83）days.（7）Among them,22 patients suffered ascites,19 patients suffered hypoproteinemia,8 patients suffered abdominal and biliary infection respectively.（8）94.55% patients（104 cases）got recovery or better,5.45%patients（6 cases）against-advice discharged and none died.[Conclusion]Male,elder patients have a big percent in cholestatic hepatitis E cases.More than half of patients suffer decolorized stool or skin ichiness and patients suffering skin ichiness have longer mean hospitalization days.The peak value of TBA appeared earlier than TBIL and ALP.