天津地区乙型重型肝炎患者血清和肝组织HBV—M表达及其临床意义

Serum and Tissue HBV-M Expressions and Clinical Significance of Severe Hepatitis B in Tianjin Area

98例乙重肝血清HBV-M表达分为:Ⅰ.活动感染型;Ⅱ.高复制型;Ⅲ,反应增强型;Ⅳ.HBV_2型。四型的肝性昏迷率、PTA均值及病死率比较差异均不显著,因此HBV-M表达类型与病情严重程度及预后无相关性。Ⅰ、Ⅱ、Ⅳ型中急重肝和亚重肝所占比例差异均显著,但Ⅲ型中两型所占比例差异不显著,表明Ⅲ型多表现为暴发性过程,Ⅰ型多为亚急性,Ⅱ、Ⅳ型仅出现于亚急性病人;急重肝与亚重肝发病机制不同;不同HBV-M表达类型病人宜采用不同的治疗方法。此外HBV_2型占5.1％,提示天津地区重型肝炎中亦有HBV_2感染。

Serum HBV markers in 98 patients with severe hepatitis B were divided to fourtypes, such as active infection, high replication, increased reaction and HBV_2 type.There were no statistically significant differences in the hepatic coma rate, PTA meanvalue and death rate among the four types, and it was indicated that the type ofserum HBV markers expression had no correlation with the severity or the prognosis.The proportion of acute severe hepatitis cases and subacute severe hepatitis cases inincreased reaction type had marked difference. Five of the 98 (5. 1%) patients were withHBV_2 infection.