【摘要】 目的研究散发性戊型肝炎(hepatitis E,HE)的流行病学特点、临床特征,探讨戊型肝炎病毒血症特点。方法对253例戊型肝炎患者进行回顾性分析,根据年龄、感染情况,将其分为老年组和非老年组、单纯感染组和重叠感染组;应用逆转录套式PCR法对38例单纯戊型肝炎的血清标本进行戊型肝炎病毒RNA(HEV RNA)检测,根据检测结果分为HEV RNA阳性组和阴性组。结果重叠组血清总胆红素(TBIL)、白蛋白(ALB)、γ-谷氨酸转肽酶(GGT)与单纯组比较,存在显著差异(P<0.05)。老年组血清ALB、TBIL与非老年组比较,存在显著差异(P<0.05)。PCR检测血清HEV RNA阳性9例;HEVRNA阳性组的肝功水平、重型肝炎发生率及肝功恢复时间与HEV RNA阴性组的比较,差异无统计学意义(P>0.05)。结论散发性戊型肝炎可与其他病毒性肝炎重叠感染;老年人、重叠感染者,肝功能损害重。在疾病的早期存在病毒血症,持续时间短;HEV RNA在体内的存在情况,与肝损害程度、病情轻重、病程长短无相关性。更多还原

【Abstract】 Objective To study the clinical and epidemiological features of sporadic hepatitis E(HE).To explore the viremia in the patients with sporadic hepatitis E.Methods Two hundred and fifty-three patients with HE were analyzed retrospectively.According to age and infection,they were divided into old age group and non-elderly group,without superinfection group and superinfection group.HEV RNA was detected in sera of the 38 patients with sporadic HE by reverse transcription-nested-polymerase chain reaction.According to test results,they were divided into HEV RNA positive group and negative group.Results The levels of bilirubin,albumin and aminopherase were significantly different between the groups with superinfection and without superinfection.There were significant differences in the levels of ALB and TBIL between old age group and non-elderly group.Nine of serum specimens were detected HEV RNA by RT-nPCR.The level of liver function,the degree of liver damage and clinical outcome were not significantly different between the groups with HEV RNA positive and HEV RNA negative.Conclusion HE could superinfect with other hepatitis viruses.The liver function of old patients or the patients with superinfection is heavily damaged.The patients with sporadic HE have viremia at the earlier time after the onset of disease;The biochemical indications of serum,degree of seriousness,the course of disease length has no relationship with the existence of HEV RNA.更多还原