Mel'nik G V
Sov Med. 1991(1):16-8.
Viral hepatitis A was diagnosed in 69.35 percent of the 124 patients with viral hepatitides aged 15 to 62, 54.1 percent of these females and 45.9 percent males, and viral hepatitis B in 30.65 percent. The disease course varied in severity, was typical in all cases; the icteric form was observed in all the patients. An unfavorable pyoinflammatory premorbid background was present in 1/3 of the examinees. The studies have revealed that a staphylococcal superinfection with the icteric syndrome contributed to the pathogenesis of viral hepatitis. Antistaphylococcal agglutinins were detected in 65.6 percent of hepatitis A and in 73.7 percent of hepatitis B patients, and alpha antitoxins in 81.1 and 71.0 percent of patients, respectively. The disease severity correlated with high antitoxin titers, high antitoxin titers with a delayed convalescence of viral hepatitis A patients. Changes in the titers of antistaphylococcal agglutinins in hepatitis B patients were not rapid and their time course correlated with the terms of liver function recovery. The author comes to a conclusion that bacterial superinfection contributes to the pathogenesis of viral hepatitides, staphylococcal infection among other ones, that essentially influences the disease course.
在124例年龄在15至62岁的病毒性肝炎患者中，甲型病毒性肝炎的诊断率为69.35%，其中女性患者占54.1%，男性患者占45.9%；乙型病毒性肝炎的诊断率为30.65%。疾病病程严重程度各异，所有病例均为典型病例；所有患者均出现黄疸型。三分之一的受检者存在不良的脓性炎症性发病前背景。研究表明，伴有黄疸综合征的葡萄球菌重叠感染促进了病毒性肝炎的发病机制。在甲型肝炎患者中，65.6%检测到抗葡萄球菌凝集素，在乙型肝炎患者中，73.7%检测到抗葡萄球菌凝集素；分别在81.1%和71.0%的患者中检测到α抗毒素。疾病严重程度与高抗毒素滴度相关，甲型病毒性肝炎患者抗毒素滴度高且恢复期延迟。乙型肝炎患者抗葡萄球菌凝集素滴度变化不迅速，其时间进程与肝功能恢复时间相关。作者得出结论，细菌重叠感染，尤其是葡萄球菌感染，促进了病毒性肝炎的发病机制，对疾病病程有重要影响。
