论文部分内容阅读
目的 研究慢性乙型肝炎（ＣＨＢ） 和慢性乙型重症肝炎（ＣＳＨＢ）患者合并巨细胞病毒感染状况及其对病情发展、预后的影响。方法 对８３３ 例ＣＨＢ、７８ 例ＣＳＨＢ患者及１００ 例正常人检测血清抗－ ＣＭＶ－ＩｇＭ及肝功能，并将ＣＨＢ与ＣＳＨＢ组中抗－ ＣＭＶ－ ＩｇＭ 阳性者与单纯ＨＢＶ感染者进行对比。结果 正常对照、ＣＨＢ及ＣＳＨＢ组血清抗－ ＣＭＶ－ ＩｇＭ 的检出率分别为１－０ ％ （１／１００） ，２－５％ （２１／８３３） 及１１－５％ （９／７８），ＣＳＨＢ 组中抗－ＣＭＶ－ＩｇＭ的阳性率显著高于正常对照及ＣＨＢ组（ Ｐ＜０－０５） 。在ＣＨＢ中，抗－ ＣＭＶ－ＩｇＭ 阳性者血清总胆红素（ＳＢ）及丙氨酸转移酶（ＡＬＴ）均显著高于单纯ＨＢＶ感染者（ Ｐ＜ ０－０５） 。在ＣＳＨＢ 中，抗－ ＣＭＶ－ＩｇＭ 阳性者病死率达８７－５％ （７／８） ，高于单纯ＨＢＶ感染者的７１－９％ （２３／３２） 。结论 ＣＨＢ，ＣＳＨＢ 患者合并巨细胞病毒感染可加重病情，尤其ＣＳＨＢ患者抗－ ＣＭＶ－ＩｇＭ 阳性率较高，合并ＣＭＶ感染者预后甚差。
Objective To study the status of cytomegalovirus infection in patients with chronic hepatitis B (CHB) and chronic severe hepatitis B (CSHB) and its effect on the progression and prognosis of the disease. Methods Serum anti-CMV-IgM and liver function were measured in 833 CHB patients, 78 CSHB patients and 100 normal controls. The anti-CMV-IgM positive patients in CHB and CSHB groups were compared with HBV-infected patients. Results The positive rates of serum anti-CMV-IgM in CHB and CSHB were 1-0% (1/100), 2-5% (21/833) and 11-5% (9/78), respectively The positive rate of anti-CMV-IgM in CSHB group was significantly higher than that in normal control group and CHB group (P <0-05). In CHB, serum total bilirubin (SB) and alanine aminotransferase (ALT) were significantly higher in patients with anti-CMV-IgM than those with HBV alone (P <0-05). In CSHB, the mortality rate was 87-5% (7/8) in anti-CMV-IgM positive patients, which was higher than 71-9% (23/32) in HBV-infected patients. Conclusions Patients with CHB and CSHB complicated with cytomegalovirus may exacerbate the disease. In particular, the positive rate of anti-CMV-IgM in patients with CSHB is high, and the prognosis is poor with CMV infection.