丁型病毒性肝炎的临床观察

目的]　探讨丁型肝炎(HD)的临床特点,了解HD患者肝炎后肝硬化、重症肝炎的发生率。方法]　用酶联(ELISA)法检测3460例乙型肝炎(HB)患者血清HDAg、抗HD-IgM,提出HB重叠HDV感染者的临床特点。结果]　HDV的感染率7.2%,250例HDV感染者起病隐匿占43.6%,有HB家族史28.8%,有明确输血史14.8%,有多次肝炎复发史者占48.8%,肝炎后肝硬化达46.0%,重症肝炎发生率14.4%。病死率14.0%。HD患者血清HBV-DNA阳性率88.8%,提示HBV复制与HDV感染呈正相关。结论]HD的肝硬化及重症肝炎发生率高于其他各型病毒性肝炎,HBV和HDV感染有相加或协同作用,导致肝损害加重并加速肝纤维化的形成。

Clinical observation of viral hepatisis D

Objective] To investigate the clinical characteristics of hepatitis D and to understand the incidences of liver cirrhosis and hepatitis gravis after hepatitis D infection. Method] HDV-Ag and Anti-HDV-IgM were detected by ELISA in 3460 cases of HB patients,which indicated the clinical characteristics of HD patients coinfected with HB. Results] The incidence of HDV infection was 7.2%. In 250 cases of HD patients,the incidence without definite disease cause was 43.6%,with HB family history was 28.8%,with definite blood transfusion history was 14.8%,with multiple relapse history of hepatitis 48.8%,with liver cirrhosis was 46.0%,with hepatitis gravis was 14.4%.The mortality of HD was 14.0%.The positive rate of sera HBV-DNA in HD patients was 88.8%,which indicated that the duplicate of HBV was correlated with HDV infection. Conclusion] The incidence of liver cirrhosis and hepatitis gravis in HD is higher than that in other viral hepatitis,HBV and HDV infections have accumulative or synergetic effect,which result in aggravation of hepatic damage and accelerated formation of liver fibrosis.