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目的 探讨散发性戊型肝炎的临床和血清学特征。方法 对 117例散发性戊型肝炎的临床表现、血清学检查进行回顾性分析。结果 6 0岁以上组肝功能TBil、DBil、GGT与 6 0岁以下组相比较 ,存在显著差异 (P <0 .0 5 ) ;117例单纯戊型感染 94例 (80 .3% ) ,甲、乙、戊型重叠感染 3例 (2 .6 % ) ,甲、戊型合并感染 10例 (8.5 % ) ,乙、丙、戊型重叠感染 1例 (0 .8% ) ,乙、丁、戊型重叠感染 2例 (1.7% ) ,乙、戊型重叠感染 7例 (6 .0 % )。 117例血清抗 HEV阳性 113例 ,其中 113例血清HEV RNA阳性 4 2例 (37.2 % ) ,余 4例血清抗 HEV阴性而血清HEV RNA阳性 (19例已知肝炎病毒标志物均阴性的急性肝炎患者 ,血清HEV RNA阳性 4例 (2 1.1% )。结论 散发性戊型肝炎老年患者黄疸发生率高 ,且淤胆现象多见 ;目前临床检测的抗 HEV是诊断戊型肝炎的主要方法 ,感染HEVⅣ型或HEV变异株的戊型肝炎 ,可用RT PCR方法检测HEV RNA确诊。
Objective To investigate the clinical and serological features of sporadic hepatitis E. Methods The clinical manifestations and serological tests of 117 cases of sporadic hepatitis E were retrospectively analyzed. Results The liver function TBil, DBil and GGT in 60 years old group were significantly different from those in the group of 60 years old (P <0.05), 94 cases (n = 3 cases (2. 6%) had overlapping infection with type B and E, 10 cases (8.5%) with type A and type E infection, 1 case (0.8%) with overlapping infection with type B, Two cases of overlap infection of pentyleneterase (1.7%), 7 cases of overlapping infection of type B and E (6.0%). Of the 117 serum samples, 113 were positive for HEV, of which 113 were positive for HEV RNA in 42 (37.2%) and the other 4 were negative for HEV and positive for HEV RNA (19 were known to have negative hepatitis A virus markers The positive rate of HEV RNA was 4 (21.1%) in the patients.Conclusion The incidence of jaundice in elderly patients with sporadic HEV is high and the cholestasis is common. Currently, the clinical detection of anti-HEV is the main method of diagnosis of hepatitis E infection HEV type IV or HEV mutant hepatitis E, RT PCR method can be used to confirm the diagnosis of HEV RNA.