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韩国近期甲型肝炎的实验室特征:持续的流行病学转变。

Laboratory characteristics of recent hepatitis A in Korea: ongoing epidemiological shift.

机构信息

Department of Laboratory Medicine, Konkuk University School of Medicine, Konkuk University Medical Center, 4-12, Hwayang-dong, Gwangjin-gu, Seoul 143-729, South Korea.

出版信息

World J Gastroenterol. 2010 Mar 7;16(9):1115-8. doi: 10.3748/wjg.v16.i9.1115.

Abstract

AIM

To evaluate seroprevalence of hepatitis A virus (HAV) antibody and investigate demographic, clinical, and laboratory features of recent cases in Korea.

METHODS

For the evaluation of hepatitis A seroprevalence, we analyzed the data from 3127 subjects including, healthcare workers and patients who visited Konkuk University Hospital, a secondary referral center, from January to October 2009. The sera with positive IgM were excluded from seroprevalence data for total HAV antibody. We retrospectively reviewed the electronic medical records of 419 patients with HAV, who were diagnosed by the presence of serum IgM antibodies against HAV. All patients presented at Konkuk University Hospital between August 2005 and September 2008.

RESULTS

Among 3127 sera tested, 1428 (45.7%) were positive for anti-HAV antibody. The seroprevalence was very low in teenagers or those in their twenties, increased in those in their thirties, and was > 90% in older patients. In children younger than 10 years, seroprevalence was increased again. Most patients with HAV hepatitis were in their twenties and thirties. The gamma-glutamyl transpeptidase increased with age and was significantly higher in patients older than 30 years. Indicators of severity, such as decreased albumin and increased bilirubin, were also more prominent in the older age group; however, the leukocyte count was higher and the frequency of leukopenia was lower in younger patients than in older adults.

CONCLUSION

There has been an apparent epidemiological shift in HAV seroprevalence and a change in the peak age of HAV hepatitis. This study could provide baseline data of recent hepatitis A in Asia.

摘要

目的

评估甲型肝炎病毒(HAV)抗体的血清流行率,并调查韩国近期病例的人口统计学、临床和实验室特征。

方法

为了评估甲型肝炎血清流行率,我们分析了 2009 年 1 月至 10 月期间,3127 名包括保健工作者和就诊于韩国孔敬大学医院(二级转诊中心)的患者的数据。排除血清 IgM 阳性的血清用于总 HAV 抗体的血清流行率数据。我们回顾性分析了 419 例甲型肝炎患者的电子病历,这些患者通过血清 IgM 抗体对 HAV 的存在而被诊断。所有患者均于 2005 年 8 月至 2008 年 9 月期间在孔敬大学医院就诊。

结果

在 3127 份检测血清中,1428 份(45.7%)对 HAV 抗体呈阳性。青少年或二十多岁的人血清流行率很低,三十多岁的人增加,年龄较大的人> 90%。10 岁以下的儿童再次增加了 HAV 肝炎的血清流行率。大多数甲型肝炎患者年龄在二十多岁和三十多岁。随着年龄的增长,γ-谷氨酰转肽酶增加,年龄在 30 岁以上的患者明显更高。严重程度的指标,如白蛋白减少和胆红素增加,在年龄较大的组中更为突出;然而,白细胞计数在年轻患者中更高,白细胞减少症的频率在年轻患者中低于老年患者。

结论

HAV 血清流行率出现了明显的流行趋势变化,HAV 肝炎的发病高峰年龄也发生了变化。本研究可为亚洲近期甲型肝炎提供基线数据。

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