庚型肝炎病毒致病性的临床研究

目的:调查庚型肝炎病毒(HGV)在各型病毒性肝炎中的感染率和探讨其对临床可能的影响。方法:以巢式逆转录PCR法检测1997年1月-1999年12月住院的5024例患者血清中HGV 5’NCR和NS5b基因片段,两者均检出判定为HGV感染,同时与临床类型、肝功能、疾病转归进行比较。结果:①5024例肝病患者中550例检出HGV RNA,总的感染率为10.9％,其中慢性肝炎、重型肝炎的感染明显高于急性非甲-戊型、急性甲型和急性乙型肝炎(14.2％和15.8％ vs 7.8％、4.6％、8.3％,P<0.05)。②急性戊型肝炎合并HGV感染率高达14.2％,明显高于其他急性病毒性肝炎(P<0.05)。③重叠HGV感染与否并不影响各型肝炎的肝功能损害程度,也不影响重型肝炎患者的存活率(61.43％ vs 59.85％,P>0.05)。④27例单一感染HGV的惠性肝炎患者。均临床治愈出院,HGV的病毒血症与肝炎的临床表现没有相关性,37％(10/27)患者在6个月随访期中在肝功能恢复正常后仍有HGV病毒血症。结论:①HGV感染可发生于各型病毒性肝炎患者。②急性戊型肝炎合并HGV感染明显高于其他急性病毒性肝炎的原因,值得进一步探讨。③HGV感染对人类没有重要的致病性,HGV感染不是原因不明的非甲-戊型肝炎的主要病因。

Clinical Study on the Pathogenicity of HGV

Objective: To investigate the rate of HGV infection and explore the potential impact of the infection by HGV on different types of viral hepatitis. Method: HGV RNA was determined with nRT PCR by both positive for5' NCR and NS5b gene fragments of HGV in 5024 patienst admitted in our hospital from 1997. 1to 1999.12 and compaired with clinical types of viral hepatiits, liver functions and clinical outcomes. Results: (1)550 patients were positive for HGV RNA with a total rate of 10.9% of HGV infection in 5024 detected patients, among which the rates of HGV infection were much higher in chronic and severe hepatitis than in acute nonA-E, A and B hepatits (14.2% and 15.8%vs. 7.8%, 4.6%, 8.3%, P< 0.05). (2)The rate of HGV infection was of 14.2% in acute hepatitis E and significantly higher than in other actue hepatitis (P<0.05).(3)There were no differences in the degree of hepatic damages between different types of viral hepatitis and in the survival rate in the severe hepatitis with of without the infection by HGV (61.43%vs. 59.85% , P<0.05). 4. 27 patients with acute hepatitis determined positively for only HGV were clinically cured. The disease coruse of hepatitis was not associated with the virusemia of HGV. 37% (10/27) patients maintained their virusemia of HGV even after their liver functions returned to be normal during the 6 - month following. Conclusion: (1) The infection by HGV was common in patients with different vi- ral hepatitis. (2)It needs a further study on why co- infection of HGV in acute hepatiits E was much higher than in other acute hepatitis. (3)HGV was not a important pathogenically factor for human being and the infection by HGV was not the major cause of the unknown nonA- E viral hepatitis.