单纯 HBV 感染和 HBV HDV 重叠感染者血清标志物的比较

目的：通过比较单纯乙型肝炎病毒（HBV）和乙丁型肝炎病毒（HBV HDV）重叠感染的患者血清中 ALT、HBV DNA及 HBV 血清学标志（HBVM）等的异同，了解 HBV HDV 重叠感染特点，初步探讨 HDV 的致病机理。方法对95例 HBV HDV 重叠感染的患者生物化学指标、肝炎病毒标志物等作统计分析，以100例单纯 HBV 感染患者作为对照。结果在95例重叠感染者中，慢性乙型肝炎发生率最高，占66．32％，肝硬化次之。按 HBV DNA 载量分类，两者差异无统计学意义（P ＞0．05），重叠感染组 ALT 异常率与 HBV DNA 呈正相关（r ＝0．90，P ＜0．05）。重叠感染组以 HBeAg 阴性模式为主（P ＜0．05），按HBsAg＞250 IU/mL 统计，差异无统计学意义（P ＞0．05）；按 HBsAg＞250 IU/mL 且 HBeAg ＞1 S/CO 统计时，单纯 HBV 组高于重叠感染组（P ＜0．05）。HBcAb-IgM 阳性率在重叠感染组中明显高于单纯 HBV 感染（P ＜0．05）。结论乙、丁型肝炎病毒重叠感染在慢性 HBV 中的发生率高。随着 HBV 病毒 DNA 数量的增加，肝功能的异常率也增高，HDV 感染能抑制 HBeAg 表达，重叠感染组中 HBcAb-IgM 阳性率高，可能与慢性乙型肝炎病情加重反复有关。

Comparison of serum markers between pure hepatitis B infection and superinfection of hepatitis B together with hepatitis D

Objective To understand the characteristics of the superinfection of hepatise B virus （HBV）together with hepatitis D virus（HDV）by comparing the differences of serum markers ALT,HBV DNA,HBVM,etc.In the pure HBV infection and the superinfection of HBV and HDV and to preliminarily invesitigate the pathogenesis of HDV.Methods The results of major bio-chemical indicators and hepatitis virus markers in 95 cases of HBV together with HDV infection and 100 cases of pure HBV infec-tion as the control group were statistically analyzed.Results Among 95 cases in the superinfection group,the incidence rate of chronic HBV was the highest,accounting for 66.32% and followed by liver cirrhosis.There was no statistical difference between the two groups according to the HBV DNA loads（P 〉0.05）.The good positive correlation existed between the ALT abnormal rate of the liver function and HBV DNA in the superinfection group（r=0.90,P 〈0.05）.The HBeAg negative mode was predominant in the superinfection group （P 〈0.05 ）.There was no difference beween the two groups according to HBsAg 〉 250 IU/mL （P 〉0.05）.According to HBsAg〉250 IU/mL and HBeAg 〉 1 S/CO,the pure HBV infection group was higher than the super infec-tion group （P 〈0.05）.The positive rate of HBcAb-IgM in the super infection group was significantly higher than that in the pure HBV group （P 〈0.05）.Conclusion The superinfection of HBV together with HDV infection has the high occurrence rate in chro-nic hepatitis B.With the HBV DNA level increase,the abnormal rate of the liver function is also increased.HDV infection can inhib-it the HBeAg expression.The high positive rate of HBcAb-IgM in the superinfection patients might be related with chronic hepatitis B aggravation and recurrence.