【摘要】 目的　阐明乙型肝炎病毒慢性感染基础对散发性甲型肝炎临床表现、肝功能指标、血清学规律和预后的影响。方法　比较分析85例慢性乙型肝炎重叠散发性甲型肝炎患者和 2 67例散发性甲型肝炎患者的发病年龄、住院时间 ;症状明显期血清谷丙转氨酶(ALT)、总胆红素 (TB)、谷氨酰转移酶 (GGT)、碱性磷酸酶 (ALP)和凝血酶原时间 (PT)的水平 ;不同病周抗 -HAV -IgM、抗 -HAV -IgG的阳性率以及病死率。 结果　二组患者的住院时间、TB、GGT、ALP和PT水平以及病死率比较 ,差异有或有高度显著性 (P <0 .0 5 ,0 .0 1 )。而发病年龄、ALT水平以及第一、二、三～四和五～十六病周抗 -HAV -IgM、抗 -HAV -IgG的阳性率 ,二组之间无统计学差异 (P >0 .0 5)。结论　乙型肝炎病毒慢性感染基础虽然使散发性甲型肝炎患者肝内瘀胆程度减轻 ,对散发性甲型肝炎抗 -HAV -IgM、抗 -HAV -IgG的血清学出现规律无影响 ;但能引起散发性甲型肝炎患者的肝功能损害加重 ,住院时间延长并且预后差更多还原

【Abstract】 Objective To investigate the clinical manifestations, indexes of liver function,regulations of serology and prognosis of sporadic hepatitis A affected by chronic infection of hepatitis B virus. Methods To Analyze the attack age, hospitalized course,serumal alanine aminotransferase(ALT),total blilirubin(TB), glutamyl transpetidase(GGT), alkaline phosphatase(ALP), prothrombin time(PT) on the period of apparent manifestation;anti-HAV-IgM, anti-HAV-IgG in the various weeks after onset and mortality in 85 cases with chronic hepatitis B superinfected with sporadic hepatitis A and 267 cases with sporadic hepatitis A. Results There are significant differences in hospitalized coures;the levels of TB,GGT ALP and PT as well as mortality between the group of chronic hepatitis B suffered with sporadic hepatitis A and group of sporadic hepatitis A (P<0.05,P<0.01).Otherwise, there is no differences in attack age;the level of ALT and anti-HAV-IgM,anti-HAV-IgG positive rates after onset in the two groups (P>0.05). Conclusion Although chronic infection of hepatitis B virus declines the degree of cholestasis and does not affect the serologic regulations of anti-HAV-IgM, anti-HAV-IgG in sporadic hepatitis A; It results in aggravated liver functions, prolonged hospitalized course and made poor prognosis.更多还原