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目的 为了查清慢性乙型肝炎 (慢性乙肝 )病程中发生致死性重型肝炎与重叠感染甲、丙、丁或戊型肝炎病毒以及乙肝病毒 (HBV)e系统状态的关系 ,以便采取相应措施降低慢性乙肝的死亡率。方法 用ELISA法检测慢性乙肝病程中发生致死性重型肝炎时重叠甲、丙、丁或戊型肝炎病毒的感染情况以及HBVe系统的状态。结果 在慢性乙肝病程中发生致死性重型肝炎的 2 19例患者中 ,甲、丙、丁或戊型肝炎病毒的重叠感染率分别为 1. 4 % (3 /2 19)、9.6 % (2 1 2 19)、1.8% (4 2 19)和30.1% (6 6 / 2 19) ,重叠嗜肝病毒的感染率之和为 4 2.9% (94 2 19)。其中 ,以戊型肝炎病毒为主 ,并且近10年来感染率基本没有改变。原因未明者为 5 7.1% (12 5 2 19)。HBeAg和抗 HBe的阳性率在甲、丙、丁或戊型肝炎病毒重叠感染组分别为 17.0 % (16 94 )和 5 4.0 2 % (5 1 94 ) ;原因未明组分别为 2 7.2 %(34 /12 5 )和 4 7.2 % (5 9/12 5 ) ,两组之间HBeAg和抗 HBe阳性率的比较差异无统计学意义 (P >0 .0 5 )。结论 研究结果提示 ,重叠嗜肝病毒感染是发生致死性重型肝炎的重要原因 ;严格饮食卫生和使用安全的血液制品可降低慢性乙肝的死亡率。未能发现HBVe抗原的血清转换与慢性乙肝患者病程中发生致死性重型肝炎有明确的关系
Objective To find out the relationship between lethal severe hepatitis and the status of overlapping A, C, D or E hepatitis and hepatitis B virus (HBV) e in the course of chronic hepatitis B (chronic hepatitis B) in order to take corresponding measures to reduce the chronic Hepatitis B mortality. Methods The infection status of hepatitis A, C, D or E and hepatitis B virus (HBVe) system in chronic severe hepatitis during chronic hepatitis B were detected by ELISA. Results The over-infection rates of A, C, D or E were 1. 4% (3/2 19) and 9.6% (2 1) in 2 of 19 patients with fatal severe hepatitis in the course of chronic hepatitis B 2 19), 1.8% (4 2 19) and 30.1% (6 6/2 19) respectively. The sum of infection rates of overlapping hepadnavirus was 42.9% (94 2 19). Among them, mainly hepatitis E virus, and the infection rate in the past 10 years has basically remained unchanged. The reason for the unknown is 5 7.1% (12 5 2 19). The positive rates of HBeAg and anti-HBe were 17.0% (16 94) and 5 4.02% (5 1 94) respectively in the cases of overlap infection with hepatitis A, C, D or E, respectively; 2 7.2% / 12 5) and 42.2% (5 9/12 5) respectively. There was no significant difference in the positive rates of HBeAg and HBeAg between the two groups (P> 0.05). Conclusions The results suggest that overlapping hepadnavirus infection is an important cause of fatal severe hepatitis; strict diet hygiene and the use of safe blood products can reduce chronic hepatitis B mortality. There is a clear relationship between the failure to detect seroconversion of HBVe antigens and the development of lethal severe hepatitis in the course of chronic hepatitis B