论文部分内容阅读
目的 研究重型病毒性肝炎的不同病毒病因与预后的关系。方法 用回顾性研究方法,比较1994～1998年间87例重型肝炎不同病毒感染类型的发生率与病死率的关系。结果 87例重型肝炎患者总病死率7471%(6587),其中单独HBV感染占4138%(3687)。68例慢性重型肝炎患者中,单独HBV感染28例(4118%);2种以上病毒混合感染40例(5882%),即HBV+HEV或HAV19例(2794%),HBV+巨细胞病毒(CMV)7例(1029%),HBV+HCV4例(588%)等,病死率最高为HBV与CMV混合感染(8571%),其次为单独HBV感染(7778%)。急性或亚急性重型肝炎19例,单独HBV感染率为4211%(819)、病死率均较高,而单独HAV或HEV感染率占3685%(719),但病死率较低。结论 单独HBV、HAV或HEV是引起重型肝炎的主要病毒病因,2种以上病毒混合感染是慢性重型肝炎最常见的病毒感染类型,HBV与CMV混合感染预后较差。慢性乙型肝炎患者避免重叠感染HAV或HEV,可能有助于降低重肝发病率。
Objective To study the relationship between different viral etiology and prognosis in patients with severe viral hepatitis. Methods A retrospective study was conducted to compare the incidence of 87 different cases of severe hepatitis between different types of virus infection and mortality in 1994-1998. Results The total case fatality rate was 7471% (6587) in 87 patients with severe hepatitis, of which HBV infection alone accounted for 4138% (3687). Of the 68 patients with chronic severe hepatitis, 28 (4118%) were infected with HBV alone; 40 (5882%) were infected with two or more viruses, 19 (2794%) with HBV + HEV or HAV and HBV + CMV Seven cases (1029%) and HBV + HCV (588%) had the highest case fatality rate with mixed infection of HBV and CMV (8571%), followed by HBV infection (7778%). In 19 cases of acute or subacute severe hepatitis, the infection rate of HBV alone was 4211% (819), the mortality rate was high, while the infection rate of HAV or HEV alone was 3685% (719), but the mortality rate was lower. Conclusions HBV, HAV or HEV alone is the main cause of severe hepatitis. Mixed infection of two or more viruses is the most common type of virus infection in chronic severe hepatitis, and the prognosis of mixed infection with HBV and CMV is poor. Chronic hepatitis B patients avoid overlapping infection with HAV or HEV may help reduce the incidence of severe liver disease.