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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
Objective To clarify the effect of chronic hepatitis B virus infection on the clinical manifestations, liver function, serological rules and prognosis of sporadic hepatitis A. Methods The age of onset and hospital stay of 85 hepatitis B patients with overlapping sporadic hepatitis A and 2 67 patients with sporadic hepatitis A were analyzed. The levels of serum alanine aminotransferase (ALT), total bilirubin (TB) ), Glutamyl transferase (GGT), alkaline phosphatase (ALP) and prothrombin time (PT). The positive rate of anti-HAV-IgG and anti-HAV- Results There were significant differences in hospitalization time, TB, GGT, ALP and PT levels and case fatality between the two groups (P <0.05, 0.01). The incidence of anti-HAV-IgM and anti-HAV-IgG in the first, second, third to fourth, and fifth to sixty-six weeks of age showed no significant difference between the two groups (P> 0.05). 0 5). Conclusion Although the basis of chronic hepatitis B infection reduces the degree of intrahepatic cholestasis in patients with sporadic hepatitis A, it has no effect on the serological appearance of anti-HAV-IgM and anti-HAV-IgG in patients with sporadic hepatitis A; Causing exacerbation of liver damage in patients with sporadic hepatitis A, prolonged hospital stays, and poor prognosis