摘要
目的分析2008～2010年云南省394例散发性急性戊型肝炎流行病学特点和临床特征。方法回顾性调查2008～2010年云南省394例散发性急性戊型肝炎患者的临床资料。结果 394例散发性急性戊型肝炎(AHE)患者中,男女比例为1.432:1;平均年龄31.53±18.12岁,其中18岁以下患者94例(23.86%),18～60岁患者271例(68.78%),60岁以上患者29例(7.36%);夏季发病率显著增高(P=0.000),尤其是5和7月份,发病率分别达到了14.72%和13.71%;职业分布以民工所占比例最高(26.90%);民族分布以汉族患者所占比例最高(92.64%)。男性患者的住院时间、总胆红素和丙氨酸氨基转移酶峰值均高于女性患者,差异具有统计学意义(P<0.05);随年龄增长,患者住院时间延长,ALT、ALB及CHE呈下降趋势,TBil呈上升趋势,差异具有统计学意义(P<0.05)。分别重叠慢性乙型肝炎、酒精性脂肪肝或非酒精性脂肪肝的患者与AHE组患者比较,TBil、TBA、GGT及CHE差异具有统计学意义(P<0.05),抗-HEV-IgG阳性患者与抗-HEV-IgM阳性患者在住院时间及各项血清生化学指标比较差异均无统计学意义。结论 AHE多发于18～60岁人群,男性发病多于女性,夏季为发病高峰,民工高发。绝大多数患者预后良好。60岁以上发病,CHB、AFL及NAFLD基础上重叠感染HEV可能是直接影响AHE预后的主要因素。
Objective To analyze the epidemiological characteristics and clinical features of 394 cases with sporadic acute viral hepatitis E（AHE） in Yunnan Province from the year 2008 to 2010.Methods Clinical data of 394 cases with sporadic AHE from the year 2008 to 2010 in Yunnan Province were reviewed,retrospectively.Results Among 394 cases with sporadic AHE,the ratio of male/female was 1.432：1,and the mean age was 31.53 ± 18.12 years old.There were 94（23.86%） patients aged below 18 years old,271（68.78%） patients aged between 18 and 60 years,and 29（7.36%） patients aged above 60 years.The incidence rate was significantly increased in summer（P=0.000）,especially in May（14.72%） and July（13.71%）.In addition,the characteristics of occupation distribution were migrant labourers,there were 106 patients（26.90%） in this group and the characteristics of ethnic groups distribution were Han people,with 365 patients（92.64%） in this group.The length of hospital stay,the peak value of total bilirubin and alanine aminotransferase in male patients were significantly higher than those in female patients（P〈0.05）.With the patients＇ prolonged hospital stay and older age,the levels of ALT,ALB,CHE decreased and levels of TBil increased（P〈0.05）.Then there were significant differences in peak values of TBil,TBA,GGT,CHE between AHE group and groups of AHE complicated with CHB,AFL,NAFLD,respectively（P0.05）.In addition,there were no significant difference in length of hospital stay and biochemical indexes between anti-HEV-IgG positive group and anti-HEV-IgM positive group.Conclusions Four epidemiological characteristics including patients aged between 18 and 60 years,male,summer and migrant labourers are found to be associated with acute hepatitis E infection.The prognosis of AHE in majority of patients is favorable,but patients aged above 60 years and complicated with CHB,AFL and NAFLD can be the factors inducing the infaust prognosis.
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2011年第4期13-17,共5页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
基金
国家高技术研究发展计划(863计划)基金资助重点项目(2006AA02A209)
