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[急性、慢性和暴发性戊型肝炎:七年经验(2004 - 2011年)]

[Acute, chronic and fulminant hepatitisE: seven years of experience (2004-2011)].

作者信息

Mateos-Lindemann Maria Luisa, Diez-Aguilar María, González-Galdamez Ana, Graus-Morales Javier, Moreno-Zamora Ana, Perez-Gracia Maria Teresa

机构信息

Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Madrid, España.

出版信息

Enferm Infecc Microbiol Clin. 2013 Nov;31(9):595-8. doi: 10.1016/j.eimc.2013.03.014. Epub 2013 Apr 30.

Abstract

OBJECTIVE

To study the clinical and epidemiological profiles of in 43cases of acute hepatitis, 5cases of fulminant hepatitis, and one of chronic hepatitis due to hepatitis E virus (HEV), detected over a 7-year period.

PATIENTS

Forty-nine individuals (33male and 10female) treated between 2004 and 2011 in the Hospital Ramón y Cajal (Comunidad de Madrid, Spain). The diagnosis was made by the detection of IgG and IgM anti-HEV and RNA HEV in serum samples. Acute hepatitisE was defined by the presence of IgM anti-HEV and/or RNA HEV in serum, and chronic hepatitisE if the ARN was detectable more than 6months. Fulminant hepatitisE was diagnosed if encephalopathy was observed in addition to IgM anti-HEV and/or RNA HEV in serum.

RESULTS

The median age was 46.67 and 49.6years in acute hepatitisE and fulminant hepatitisE, respectively. The risk factors recorded were travel to endemic areas in 13patients, 4were in contact with animals, 4suffered from hepatic steatosis due to alcohol consumption, 3consumed uncontrolled foods, and 2drank water from streams.

DISCUSSION

HEV is the cause of acute self-limited hepatitis, although 36.73% of the studied cases had to be hospitalised. However a small number of patients, 10.2%, had fulminant hepatitis requiring liver transplant. Chronic hepatitisE is very infrequent in immunocompetent individuals. The increase in incidence of hepatitisE is due to the introduction of better diagnostic tests in recent years.

摘要

目的

研究在7年期间检测出的43例戊型肝炎病毒(HEV)急性肝炎、5例暴发性肝炎和1例慢性肝炎的临床及流行病学特征。

患者

49例患者(33例男性和10例女性)于2004年至2011年在西班牙马德里自治区拉蒙·卡哈尔医院接受治疗。通过检测血清样本中的抗HEV IgG和IgM以及HEV RNA进行诊断。急性戊型肝炎定义为血清中存在抗HEV IgM和/或HEV RNA,若ARN在6个月以上仍可检测到则为慢性戊型肝炎。若血清中除抗HEV IgM和/或HEV RNA外还观察到脑病,则诊断为暴发性戊型肝炎。

结果

急性戊型肝炎和暴发性戊型肝炎的中位年龄分别为46.67岁和49.6岁。记录的危险因素包括:13例患者前往流行地区,4例接触动物,4例因饮酒患有肝脂肪变性,3例食用未受控制的食物,2例饮用溪水。

讨论

HEV是急性自限性肝炎的病因,尽管36.73%的研究病例需要住院治疗。然而,少数患者(10.2%)患有暴发性肝炎需要肝移植。免疫功能正常的个体中慢性戊型肝炎非常罕见。戊型肝炎发病率的增加是由于近年来采用了更好的诊断检测方法。

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