我国东部地区老年戊型肝炎流行病学特征

Epidemiological characteristics of elderly patients with hepatitis E in eastern China

目的调查2007-2016年我国东部地区老年戊型肝炎的流行病学特点。方法收集南京中医药大学附属解放军第八一医院2007年1月至2016年12月老年戊型肝炎患者(≥60岁)的临床资料,包括性别、年龄、地区、发病季节、肝功能、有无基础肝病和预后等,分析老年戊型肝炎发病的性别、年龄和季节特点,比较合并基础肝病患者与无并发症患者的临床特征。结果 2007年1月至2016年12月本院共收治老年戊型肝炎患者161例,均为散发,男性127例,女性34例。60～69岁、70～79岁和≥80岁年龄段发患者数分别为106例、43例和12例。161例患者中29例合并基础肝病,其中合并慢性HBV感染者16例。79例患者来自城市,82例患者来自农村。1～4季度发病例数分别为84例、44例、21例和12例。第1季度患者数最多,占发病总人数的52.2%(84/161),其次为第2季度,占27.3%(44/161)。经保肝等综合治疗,多数患者预后良好,但仍有少数患者治疗无效,共21例病死,其中男性19例,女性2例。21例病死患者中,10例合并其他基础肝病。与无并发症的戊型肝炎患者相比,有基础肝病患者的TBil值更高、PT延长、PTA降低、CHE降低、住院时间延长,差异均有统计学意义(P均<0.05)。无并发症的老年戊型肝炎患者病死率为8.3%(11/132),有基础肝病患者的病死率为34.5%(10/29),差异有统计学意义(χ2=14.3,P=0.001)。结论老年戊型肝炎主要发生在第1季度,男性患者发病率显著高于女性,有基础肝病患者的病死率显著增高。

Objective To investigate the epidemiological characteristics of elderly patients with hepatitis E in eastern China from 2007 to 2016.Methods Clinical data(including gender,age,season,region,liver function,whether underlying other liver disease or not and prognosis)of elderly patients(≥60 years old)with hepatitis E in Bayi Hospital of PLA Affiliated Nanjing University of Chinese Medicine from January 2007 to December 2016 were collected.The gender,age and seasonal characteristics of the elderly patients with hepatitis E were analyzed and the clinical characteristics between patients with and without basic liver diseases were compared.Results From January 2007 to December 2016,total of 161 elderly patients with hepatitis E were treated in our hospital,who were all sporadic.The number of male and female were 127 and 34,respectively.The numbers of patients of 60~69 years old,70~79 years old,≥80 years old were 106 cases,43 cases and 12 cases,respectively.Among the 161 patients,29 cases were with underlying basic liver diseases,including 16 cases with chronic hepatitis B.Total of 79 patients came from urban areas and 82 patients came from rural areas.The number of patients from 1~4 quarters were 84 cases,44 cases,21 cases and 12 cases,respectively.Most cases occurred in the first quarter,accounting for 52.2%(84/161),followed by the second quarter,accounting for 27.3%(44/161).After liver protective therapy and other comprehensive treatment,most patients were discharged and had a good prognosis.However,there were still a small number of patients with ineffective treatment,and 21 patients(19 males and 2 females)died of liver failure.Among the 21 dead cases,10 cases were complicated with other liver diseases.Compared with hepatitis E patients without complication,patients with basic liver diseases were with higher TBil,longer PT,lower PTA and CHE and longer period of hospitalization,the differences were statistically significant(P<0.05).The overall fatality rate of hepatitis E patients without complications was 8.3%(11/132)and the mortality rate of patients with basic liver diseases was 34.5%(10/29),with statistically significant difference(χ^2=14.3,P=0.001).Conclusions Hepatitis E in elderly patients mainly occurred in the first quarter,the incidence of male patients was significantly higher than that of female patients,and patients with basic liver diseases had a high mortality rate.