戊型肝炎合并非酒精性脂肪性肝病21例临床分析

Clinical analysis of 21 hepatitis E cases with nonalcoholic fatty liver disease

目的分析21例戊型肝炎合并非酒精性脂肪性肝病(NAFLD)患者的临床特点。方法回顾性分析21例戊型肝炎合并NAFLD患者(合并组)的临床资料,并与42例单纯戊型肝炎患者(单纯组)进行比较。结果合并组患者年龄(54.8±13.4)岁,单纯组患者年龄(51.6±11.5)岁。合并组患者发病多在春、夏季,而单纯组患者四季均有发病。合并组血清γ-谷氨酰转肽酶(GGT)水平高于单纯组[220.9(167.6,429.4)U/L vs.170.0(121.9,247.4)U/L](P<0.05)。两组均以黄疸型多见,血清ALT、AST、TBil、间接胆红素、ALP、白蛋白、TC、TG、抗戊型肝炎病毒IgG与IgM水平均无统计学差异(P>0.05)。合并组2例患者预后欠佳,单纯组均好转出院。结论应关注中老年戊型肝炎合并NAFLD患者,及时监测血清γ-GGT水平以评估病情。

Objective To analyze the clinical characteristics of 21 hepatitis E cases with nonalcoholic fatty liver disease(NAFLD).Methods The clinical data of 21 hepatitis E cases with NAFLD(group A)were analyzed retrospectively,which were compared with those of 42 cases with simple hepatitis E(group B).Results The age of the patients in group A was(54.8±13.4)years old,and that in group B was(51.6±11.5)years old.The incidence of hepatitis E complicated with NAFLD was mostly in the spring and summer,while simple hepatitis E occurred in all the seasons.Serum level ofγ-glutamyl transpeptidase(GGT)in group A was higher than that in group B[220.9(167.6,429.4)U/L vs.170.0(121.9,247.4)U/L](P<0.05).Jaundice was more common in both groups.There were no significant differences in serum levels of ALT,AST,TBil,indirect bilirubin,ALP,albumin,TC,TG,anti-HEV IgG and anti-HEV IgM between the two groups(P>0.05).The prognosis of 2 patients in group A was poor,while those in group B were all improved and discharged.Conclusion Attention should be paid to the elderly patients of hepatitis E with NAFLD,in whom serumγ-GGT level should be monitored in time to assess the condition.