病毒性肝炎__(期刊论文)

病毒性肝炎重叠感染的临床流行病学研究

http://www.100md.com 《广东药学院学报》 2003年第1期

病毒性肝炎,,病毒性肝炎；多重感染；临床流行病学；感染模式；临床危害；危险因素,1材料与方法,2结果,3讨论,参考文献

     摘要目的：探讨病毒性肝炎多重感染的模式以及对临床体征、症状的影响,研究多重感染的危险因素。方法：对1998~2000年佛山和广州两地各大医院住院的823例病毒性肝炎患者进行各型肝炎病毒标记物的检测,记录其临床症状和体征及其肝功能的检测指标,同时选择有关的对照并制定统一表格对多重感染患者和对照组进行各种可能的危险因素的调查。结果：病毒性肝炎多重感染的模式为19种,双重感染占了83.86%,多重感染中重叠乙肝感染者占了绝大多数(98.3%);乙肝多重感染组的黄疸阳性率(69.50)较单纯乙肝感染组(53.53%)为高(P<0.01);各种反映肝功能的生化指标的中位数,多重感染组明显高于单纯乙肝感染组,住院时间也明显较单纯乙肝感染组长,重症者和肝硬化者比例较单纯乙肝感染组大.多元logistic回归分析结果表明下面几种因素与多重感染有关,家庭成员肝炎史OR为27.11(4.93~149.1),牙科手术史OR为4.81(1.57~14.69);输血史OR为4.01(1.51~10.70),血液接触史OR为5.64(1.09`29.27),外餐习惯OR值2.29(1.30~4.05)。结论：病毒性肝炎多重感染模式较多,对临床有较大的影响,对人体危害较严重,恢复较慢,家庭成员肝炎史、牙科手术史、输血史、血液接触史和外餐习惯与多重感染有关。

    关键词病毒性肝炎；多重感染；临床流行病学；感染模式；临床危害；危险因素

    Clinical epidemiological study of multiple hepatitis virus infections

    WU Cuiling, CHEN Sidong,ZHANG Guanqun,WANG Baoguo2,YANG Yi

    (1.Guangzhou Center of Biological Engineering,Guangzhou,Guangdong 510450; 2.Department of Epidemiology,Guangdong College of Pharmacy)

    Abstract Objective:To explore the patterns of coinfection of hepatitis viruses and effects on clinical features and to determine the risk factors of multiple hapetitis virus infections. Methods: 823 hospitalized patients with hepatitis were selected in Guangzhou and Foshan city from 1998 to 2000 for detecting markers of different kinds of hepatitis viruses,examining liver function and investigating the clinical manifestation. Among 823 patients,233 cases were superinfection of hepatitis viruses. 408 controls were selected for investigating the risk factors of multiple hepatitis virus infections. Results :There were 19 patterns of multiple HB infections. Most of them were dualinfection of HB(83.86%) and superinfection of HBV(98.3%). Multiple infection group had more fulminant hepatitis and cirrhosis than the single HBV infection group with statistically significant difference . The incidence of jaundice was significantly higher in multiple infection group(69.50%) than that in HBV infection group(53.53%). Serum alnini aminotransferase(ALT),serum total bilirubin(BILT),serum direct bilirubin(BILD),serum indirect bilirubin(BILI) and TP,GLB,ALB,A/G were also significantly higher in multiple infection group than that in the HBV infection group. The hospitalizing time was significantly longer in patients with mutiple infection than those with HBV infection. According to the results of condition logistic multivariate regression analysis,OR of the history of hepatitis in family members was 27.11(4.93~149.1),teeth operation was 4.81(1.57~14.69);blood transfusion was 4.01(1.51~10.70),blood contact was 5.64(1.09~29.27),the outeating habit was 2.29(1.30~4.05). Conclusion:There are various patterns of multiple hepatitis virus infections . The multiple hepatitis virus infection have a great influence on clinical manifestation. The risk factors of multiple hepatitis virus infections include the history of hepatitis in family members,teeth operation,blood transfusion,blood contact and the outeating habit. ......

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