不同HCV感染途径HBV／HCV重叠感染患者临床差异分析

目的 了解不同HCV感染途径HBV/HCV重叠感染患者临床特征的差异。方法 回顾分析我院1999年5月至2010年5月间HCV和HBV重叠感染具有明确HCV感染途径的患者总133例;利用SPSS16.0软件,统计分析不同HCV感染途径HBV/HCV重叠感染患者的人口学、病毒学和生化学等指标。结果 133例患者中,78例患者因静脉吸毒感染HCV（ 1DU）,55例因输血感染HCV（PTCH）。IDU重叠感染患者与PTCH重叠感染患者相比,具有发病年龄较小、HBV和HCV感染病史较短和肝硬化比率低（P＜0.05）;但是IDU重叠感染患者体内ALT（t=4.760,P=0.000）、AST（t =3.798,P=0.000）和TBil（t =4.274,P=0.000）水平比PTCH重叠感染患者明显升高。两组患者的性别构成比率不同（X^2= 18.706,P=0.000）。结论 输血后感染HCV患者和静脉吸毒感染HCV患者临床特征存在明显差异。输血后感染丙肝患者具有发病较晚、肝硬化较多和肝损伤较轻特点;而静脉吸毒感染丙肝患者具有发病年龄早和肝损伤较重等特点。

Comparative study on the clinical characteristics of HBV/HCV co-infection patients with different HCV contaminnation mode

Objective The purpose of this study was to compare the epidemiological, biochemical and virological characteristics among patients co-infected with hepatitis B virus (HBV) and hepatitis C virus (HCV) according to the mode of HCV contamination. MethodsThe study included 133 patients with chronic HBV/HCV co-infection. They were studied and subdivided into two groups ( drug addicts group and Blood transfusion group) according to the mode of HCV contaminnation. The epidemiological, biochemical and virological characteristics were collected. Univariate analysis was performed with the SPSS 16.0. Results 78 patients were infected by the mode of drug addicts(IDU) , whereas 55 were infected by the mode of blood transfusion(PTCH). Patients in drug addicts group had yonger age, shorter HBV and HCV infection history, and lower cirrhosis percentage than those of patients in PTCH group( P ＜ 0. 05 ). However, serum levels of ALT ( t = 4. 760, P = 0. 000 ), AST( t = 3. 798, P--0. 000 ), TBil ( t = 4. 274, P = 0. 000 ) of IDU patients were higher than those of PTCH patients. There was difference of sex composition between two groups (x2 = 18. 706,P =0. 000). Conclusions The clinical characteristics of patients with HBV/HCV coinfection were significantly different among different HCV contamination mode. PTCH patients have the characteristics of older age, more cirrhosis and mild degree of liver injury; IDU patients have the characteristics of yonger age, fewer cirrhosis and severe liver injury.