134例HEV相关肝衰竭患者临床特点分析

目的 观察HEV相关肝衰竭患者的临床特点,为HEV相关肝衰竭诊治提供依据.方法 收集我院2002年1月至2012年1月收治的134例HEV相关肝衰竭患者临床资料,回顾性分析其年龄、分型、分期、转归、生化指标等临床特点,比较单纯HEV相关肝衰竭、重叠HBV感染的肝衰竭差异.结果 戊型肝炎患者中共有134例发生肝衰竭,占住院戊型肝炎总数的8.45％.单纯HEV相关肝衰竭患者68例,重叠HBV肝衰竭患者66例.两组年龄分别为(56.12±14.29)岁及(48.59±10.91)岁,两组之间比较差异有统计学意义(P＜0.05).单纯HEV感染组患者老龄患者比率(≥60岁,45.59％)明显高于重叠组患者(13.64％,P＜0.05).单纯组及重叠组患者TBil最高值无差异(P＞0.05),但单纯组ALT更高,两组分别为(1250.90±1593.97) U/L和(616.26±797.62) U/L(P＜0.05)；两组直接胆红素/总胆红素比值分别为0.72±0.07及0.69±0.08,差异有统计学意义(P＜0.05).两组肝衰竭患者病情转归、疾病严重程度比较差异无统计学意义(P＞0.05).结论 单纯HEV相关肝衰竭患者年龄较大,转氨酶较高,直接胆红素/总胆红素比值更高,但疾病严重程度及转归无明显差异.

Clinical analysis of 134 cases of HEY-related liver failure

Objective To study the clinical features of hepatitis E virus-related liver failure. Methods 134 patients with HEV-related liver failure were analyzed retrospectively. Results HEV-related liver failure accounted for 8.45 percent of the total number of hepatitis E patients in the hospital. Of the 134 patients,68 were infected with simple HEV,66 had the superinfeetion with HBV. The average age of simple HEV-related liver failure patients （56. 12 ± 14. 29） was higher than that of HBV superinfectiong liver failure patients（P 〈 0.05 ）. The ratio of elderly patients （ ≥ 60 years） in simple HEV-relatcd liver failure patients （45.59%） was significantly higher than that of the other group （ 13.64% , P 〈 0. 05 ）. The ratio of direct bilirubin/total bilirubing （ 0. 72 ± 0. 07,0.69 ± 0.08 ） , and serum alanine aminotransferase （ 1250. 90 ± 1593.97 ） U/L, （ 616.26±797.62 ） U/L ] were significantly higher in simple HEV-related liver failure patients than in HBV superinfectiong liver failure patients （ P 〈 0. 05 ）, but the total bilirubing had no significant difference （P 〉0. 05）. The disease outcome and stage were no-significant difference in the two groups（P 〉 0. 05）. Conclusion Simple HEV-related liver failure patients may have older age, higher aminotransferase, higher ratio of direct bilirubin/total bilirubin, but disease outcome and stage were nosignificant difference in the two groups.