肝脏 ›› 2021, Vol. 26 ›› Issue (11): 1221-1223.

• 病毒性肝炎 • 上一篇    下一篇

急性重症戊型肝炎临床特征及危险因素分析

陈珂, 陈榕, 王晓琳, 蔡伟   

  1. 200433 上海市第四人民医院感染科(陈珂);上海交通大学医学院附属瑞金医院感染科(郑榕,王晓琳,蔡伟)
  • 收稿日期:2021-06-30 出版日期:2021-11-30 发布日期:2021-12-24
  • 通讯作者: 蔡伟,Email:carieyc@hotmail.com
  • 基金资助:
    上海市临床重点专科(shslczdzk01103)

Analysis of clinical characteristics and risk factors of acute severe hepatitis E

CHEN Ke1, CHEN Rong2, WANG Xiao-lin2, CAI Wei2   

  1. 1. Department of Infections Diseases, Shanghai Fourth People's Hospital. Shanghai 200433, China;
    2. Department of Infections Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Received:2021-06-30 Online:2021-11-30 Published:2021-12-24
  • Contact: CAI Wei,Email:carieyc@hotmail.com

摘要: 目的 分析急性重症戊型肝炎患者的临床特征,并探究重症肝炎危险因素。方法 回顾性分析2020年12月1日—2021年5月31日上海市瑞金医院收治的102例急性戊型肝炎患者的临床资料。根据重症肝炎诊治指南分为重症组和非重症组,比较两组临床资料及实验室检查指标。结果 戊型肝炎感染以散发为主,有明确共同发病6例(5.88%),男性65例,女性37例,平均年龄(58.16±12.01)岁,平均住院天数(19.08±15.38)d,合并基础肝病对是否进展为重症未见显著差异,合并糖尿病、高血压等慢性病进展至重症者明显增多,差异有统计学意义。结论 急性戊型肝炎出现重症的患者以男性(χ2=7.474,P<0.05)、老年(F=0.979,P<0.05)、合并基础疾病者(χ2=6.544,P<0.05)明显增多,住院时间长(F=0.791,P<0.05)。同时进展至重症者白蛋白明显降低(Z=3.981,P<0.001)、总胆红素明显升高(Z=-10.575,P<0.001)、凝血功能明显异常(Z=-4.199,P<0.001)。

关键词: 戊型肝炎, 重症肝炎, 危险因素

Abstract: Objective To analyze the clinical characteristics of patients with acute severe hepatitis E and to explore the risk factors for severe hepatitis. Methods Retrospective analysis of the clinical data of 102 patients with acute hepatitis E admitted to Shanghai Ruijin Hospital from December 1, 2020 to May 31, 2021. According to the guidelines for the diagnosis and treatment of severe hepatitis, the groups were divided into severe and non-severe groups, and the clinical data and laboratory test indexes of the two groups were compared. Results Hepatitis E infection was predominantly disseminated, with clear co-morbidity in 6 cases (5.88%), 65 males and 37 females, mean age (58.16±12.01) years, mean hospitalization days (19.08±15.38) d, no significant difference was seen in the combination of underlying liver disease on whether it progressed to severe disease, and a statistically significant difference was seen in the combination of diabetes mellitus, hypertension and other chronic diseases progressing to severe disease. Conclusion Patients presenting with severe acute hepatitis E are significantly more likely to be male(χ2=7.474, P<0.05), older(F=0.979, P<0.05), and have comorbid underlying disease(χ2=6.544, P<0.05), with a statistically significant difference in length of hospital stay(F=0.791, P<0.05). It was also found that those who progressed to severe disease had lower albumin(Z=3.981, P<0.001), higher total bilirubin(Z=-10.575, P<0.001), and dysfunction of blood coagulation(Z=-4.199, P<0.001).

Key words: Hepatitis E, Severe Hepatitis, Risk factors