血吸虫性肝病合并戊型肝炎老年患者36例临床分析

发布时间：2018-04-08 08:52

  本文选题：血吸虫性肝病　切入点：戊型肝炎　出处：《中国寄生虫学与寄生虫病杂志》2015年04期

【摘要】：目的探讨老年血吸虫性肝病合并戊型肝炎老年患者的临床特点。方法将嘉兴市第一医院36例血吸虫性肝病合并戊型肝炎老年患者(观察组)与38例单纯戊型肝炎老年患者(对照组)的血常规、肝功能、凝血功能和肝纤维化血清学指标检测结果,及B超测量肝门静脉内径和脾门区脾静脉内径的结果,结合其临床表现、病程和转归情况等进行分析。结果 74例老年戊型肝炎均为急性起病。血吸虫性肝病合并感染戊型肝炎患者,病情重,易重症化。观察组患者恶心(91.7%,33/36)、呕吐(88.9%,32/36)及皮肤瘙痒(33.3%,12/36)等症状的发生率较对照组患者高(P0.05)。入院时观察组的平均总胆红素(TBIL)和丙氨酸转氨酶(ALT)水平分别为(153.22±29.71)μmol/L和(705.14±356.55)U/L均显著高于对照组[分别为(109.89±26.28)μmol/L和(485.74±297.49)U/L](P0.01或P0.05),而白蛋白(ALB)、凝血酶原活动度(PTA)、血白细胞、血红蛋白和血小板则均显著低于对照组(P0.01)。观察组的4个肝纤维化血清学指标,即透明质酸(HA)、层黏连蛋白(LN)、血清Ⅲ型前胶原肽(PⅢ)和Ⅳ型胶原(Ⅳ-C)均显著高于对照组(P0.01)。此外,在B超下测量观察组患者的肝门静脉内径和脾门区脾静脉内径,分别为(16.56±3.38)mm和(10.28±3.31)mm,均显著大于对照组[分别为(14.82±3.48)mm和(8.26±3.27)mm](P0.01)。观察组患者的肝功能恢复慢,住院时间[(43.7±7.1)d]较对照组[(29.5±5.1)d]显著延长(P0.01)。结论血吸虫性肝病合并戊型肝炎的老年患者肝脏损害较单纯戊型肝炎老年患者严重,需加强监护与治疗。
[Abstract]:Objective to investigate the clinical characteristics of elderly patients with schistosomiasis liver disease and hepatitis E.Methods Blood routine examination and liver function were performed in 36 elderly patients with schistosomiasis liver disease combined with hepatitis E (observation group) and 38 elderly patients with simple hepatitis E (control group) in Jiaxing first Hospital.The results of coagulation function and serum indexes of hepatic fibrosis, the diameter of portal vein of liver and splenic vein in portal area of spleen were measured by B-ultrasound, and the clinical manifestation, course of disease and prognosis were analyzed.Results 74 cases of senile hepatitis E were all acute onset.Schistosomiasis liver disease complicated with hepatitis E infection, the disease is serious, easy to severe.In the observation group, the incidence of nausea (91.7 / 36), vomiting (88.9 / 32 / 36) and pruritus (33.3% / 36) were higher than those in the control group (P 0.05).Hemoglobin and platelet were significantly lower than that of control group (P 0.01).The serum levels of hyaluronic acid (HA), laminin laminin (LNN), serum procollagen 鈪，

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