【摘要】 目的 探讨家族性乙型肝炎的感染途径及其对临床转归的影响。方法 采用流行病学研究方法,对279例家族性乙型肝炎感染者当面或电话询问,了解其乙型肝炎病毒(HBV)的感染途径、治疗及病情进展等情况,并对相关指标进行统计分析。结果 279例HBV感染者中母亲单方为HBV感染者占46.6%(130/279),母亲以自然分娩为主,97.2%(70/72)没有采取阻断措施。随着父母年龄的增长,其子女HBV的感染率增加,尤其是40岁以上的父母,感染率为92.9%(92/99)(χ~2=39.545,P<0.01)。抗病毒的进展率较未抗病毒的患者的疾病进展率明显降低,差异有统计学意义[25.0%(24/96)比38.8%(71/183),χ~2=5.338,P<0.05]。年龄在40岁以上的患者容易发生疾病进展。终末期肝病——乙型肝炎肝硬化、肝癌患者中,随着疾病进展,HBVe抗原(HBeAg)阳性比例减少[肝硬化38.2%(34/89)、肝癌18.2%(8/44)](χ~2=11.353,P<0.05),HBV-DNA阳性比例增加[肝硬化52.8%(47/89)、肝癌56.8%(25/44)](χ~2=5.300.P<0.05)。结论 家族性乙型肝炎的感染途径仍以母婴为主,没有采取阻断措施可能是其高感染率的主要原因;抗病毒治疗可以延缓疾病的进展、有效改善患者的预后;此外还应关注以HBeAg阴性、HBV-DNA阴性感染模式的乙型肝炎终末期肝病研究。更多还原

【Abstract】 Objective To investigate the infection route of familial hepatitis B and the impact factors on clinical outcomes.Methods Totally 279 patients with familial hepatitis B and their relatives was retrospectively observed.Results The percentage of hepatitis B virus-infected mothers was 46.6%(130/279);most of the cases were natural childbirth and 97.2%(70/72) of parents did not take blocking methods.The children hepatitis B virus infection rate was increased,especially with the parents who were over 40 years old;the infection rate was 92.9%(92/99)(χ~2 = 39.545,P< 0.01).The age of 40 years or older had a higher prevalence of disease.In the patients of end-stage liver disease such as cirrhosis and liver cancer,the proportion of HBeAg positive was reduced[cirrhosis was 38.2%(34/89),liver cancer was 18.2%(8/44),χ~2 = 11.353,P <0.05]and hepatitis B virus positive rate was increased[cirrhosis was 52.8%(47/89);liver cancer was 56.8%(25/44)](χ~2 = 5.300,P <0.05).Conclusions Route of infection of familial hepatitis B infection is still mainly mother-to-child transmission and the main reason of infection is no blocking measures.Aggressive antiviral treatment can delay the progression of the disease and improve the prognosis of patients.更多还原