关键词: 戊型肝炎, 散发性, 肝衰竭, 临床特征, 流行病学, 预后

Abstract: Objective To investigate the epidemiological characteristics, clinical features and prognosis of sporadic hepatitis E (HE).Methods The clinical data of 186 patients with sporadic HE were retrospectively analyzed. According to age, all the patients were divided into elderly group ( ≥ 60 years old) and non-elderly group ( < 60 years old). According to etiology, they were divided into super infection group and simple infection group. The clinical characteristics, laboratory examination and treatment outcome were compared between each group.Results Before treatment, the total bilirubin (TBiL) level, creatinine (Cr) level, TBiL peak value, international normalized ratio (INR) peak value, Cr peak value, incidence of skin pruritus, incidence of complications (especially urinary tract infection, spontaneous peritonitis, hypoproteinemia, hepatic encephalopathy), incidence of combined diseases, length of hospital stay and course of disease of elderly group were higher than those of non-elderly group ( P<0.05). While the levels of alanine transaminase (ALT) albumin (ALB), ALT peak, ALB valley, and the incidence of fever of elderly group were lower than those of non-elderly group ( P<0.05). After treatment, the levels of alkline phosphatase (AKP), and HYPERLINK "http://www.youdao.com/w/prothrombin time/" /l "keyfrom=E2Ctranslation" prothrombin time (PT) in non-elderly group decreased more significantly (P<0.05). And there was no significant difference in the incidence rate of liver failure, cure improvement and mortality between the 2 groups (P>0.05). Before treatment, the TBiL level, PT, INR, incidence of complications (especially spontaneous peritonitis) and incidence of acute on chronic liver failure of super infection group were higher than those of simple infection group (P<0.05). After treatment, PT of simple infection group decreased more obviously than super infection group (P<0.05), while there was no significant difference in clinical symptoms, complications rate, cure improvement rate, mortality, length of hospital stay and course of disease between the 2 groups (P>0.05).Conclusion Patients in super infection group and elderly group are more prone to hyperbilirubinemia, hypoproteinemia and coagulation dysfunction. They are more likely to be attacked by liver failure and a variety of complications, with a longer hospital stay and a poor prognosis. The content above suggests that age and super infection are main factors affecting the prognosis.

Key words: Hepatitis E, Sporadic, Liver failure, Clinical features, Epidemiology, Prognosis