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74例慢性乙型肝炎患者急性发作临床特征分析
Clinical features of patients with acute exacerbation of chronic hepatitis B: an analysis of 74 cases
文章发布日期:2016年09月28日  来源:  作者:阮建文,高丽娟,苏汝开  点击次数:1719次  下载次数:362次

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【摘要】:目的探讨慢性乙型肝炎急性发作临床特点,为诊断、治疗慢性乙型肝炎急性发作提供循证医学证据。方法回顾性分析海口市人民医院2011年1月-2015年10月确诊的74例慢性乙型肝炎急性发作患者的临床资料。将纳入患者分为HBeAg阳性组(n=51)和阴性组(n=23)。计量资料两组间比较采用t检验,计数资料组间比较采用χ2检验。结果慢性乙型肝炎急性起病,ALT水平为523~2940 U/L,表现为黄疸型肝炎64例(86.49%), 4周内临床治愈65例(87.84%)。HBeAg阳性组与HBeAg阴性组基线ALT、AST、HBV DNA水平差异均无统计学意义(P值均>0.05),但HBeAg阴性组患者的TBil水平[(141.1±132.9)μmol/L]较阳性组[(80.1±68.8) μmol/L]高,差异有统计学意义(t=2.745,P=0.007)。结论慢性乙型肝炎急性发作发病过程类似于急性乙型肝炎, HBeAg阴性患者的TBil水平较高,肝细胞损伤较重。
【Abstract】:ObjectiveTo investigate the clinical features of patients with acute exacerbation of chronic hepatitis B, and to provide a basis of evidence-based medicine for the diagnosis and treatment of acute exacerbation of chronic hepatitis B. MethodsA retrospective analysis was performed for the clinical data of 74 patients with acute exacerbation of chronic hepatitis B who were diagnosed in The People′s Hospital of Haikou from January 2011 to October 2015. These patients were divided into HBeAg positive group (51 patients) and HBeAg negative group (23 patients). The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThe patients with acute onset of chronic hepatitis B had a level of alanine aminotransferase (ALT) of 523-2940 U/L and were manifested as icteric hepatitis (64 patients, 86.49%), and 65 patients (87.84%) were cured within 4 weeks. There were no significant differences in baseline ALT, aspartate aminotransferase, and HBV DNA levels between the HBeAg positive group and the HBeAg negative group (all P>0.05), and the HBeAg negative group had a significantly higher level of total bilirubin (TBil) than the HBeAg positive group (141.1±132.9 μmol/L vs 80.1±68.8μmol/L, t=2.745, P=0.007). ConclusionThe acute exacerbation of chronic hepatitis B is similar to acute hepatitis B, and the patients with negative HBeAg have a high level of TBil and severe hepatocyte injury.
【关键字】:肝炎,乙型,慢性;临床特征
【Key words】:hepatitis B,chronic;clinical characteristics
【引证本文】:阮建文, 高丽娟, 苏汝开. 74例慢性乙型肝炎患者急性发作临床特征分析[J]. 临床肝胆病杂志, 2016, 32(11): 2096-2098.

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