Yoo Sun Ho, Kim In Hee, Jang Ji Won, Choi Chung Hwan, Moon Jin Chang, Park Jin Kyoung, Lee Sang Youn, Kim Seong Hun, Kim Sang Wook, Lee Seung Ok, Lee Soo Teik, Kim Dae Ghon, Cho Eun Young, Jung Gum Mo
Department of Internal Medicine, Research Institute of Clinical Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, 20 Geonji-ro, Deokjin-gu, Jeonju 561-712, Korea.
Korean J Gastroenterol. 2014 Jan 25;63(1):25-31. doi: 10.4166/kjg.2014.63.1.25.
BACKGROUND/AIMS: The frequency of symptomatic acute HAV infections in adulthood are increasing in Korea. This study analyzes the clinical severity in patients with acute HAV infection and investigates risk factors associated with three severe complications: prolonged cholestasis, acute kidney injury, and acute liver failure.
We performed a retrospective analysis of 726 patients diagnosed from January 2006 to December 2010 at three tertiary hospitals in Jeonbuk Province, Republic of Korea with acute HAV infection.
In the group of 726 patients, the mean age was 30.3 years, 426 (58.6%) were male, and 34 (4.7%) were HBsAg positive. Severe complications from acute HAV infection occurred as follows: prolonged cholestasis in 33 (4.6%), acute kidney injury in 17 (2.3%), and acute liver failure in 16 (2.2%). Through multivariate analysis, age ≥40 years (OR 2.63, p=0.024) and peak PT (INR) ≥1.5 (OR 5.81, p=0.035) were found to be significant risk factors for prolonged cholestasis. Age ≥40 years (OR 5.24, p=0.002) and female gender (OR 3.11, p=0.036) were significant risk factors for acute kidney injury. Age ≥40 years (OR 6.91, p=0.002), HBsAg positivity (OR 5.02, p=0.049), and peak total bilirubin (OR 1.11, p=0.001) were significant risk factors for acute liver failure.
Age ≥40 years, female gender, HBsAg positivity, peak PT (INR) ≥1.5, and peak total bilirubin were significant risk factors for severe complications in acute HAV infections.
背景/目的：在韩国，成人有症状急性甲型肝炎病毒（HAV）感染的发生率正在上升。本研究分析急性HAV感染患者的临床严重程度，并调查与三种严重并发症相关的危险因素，这三种并发症为：胆汁淤积延长、急性肾损伤和急性肝衰竭。
我们对2006年1月至2010年12月在韩国全北道的三家三级医院诊断为急性HAV感染的726例患者进行了回顾性分析。
在726例患者组中，平均年龄为30.3岁，426例（58.6%）为男性，34例（4.7%）HBsAg阳性。急性HAV感染的严重并发症发生率如下：胆汁淤积延长33例（4.6%），急性肾损伤17例（2.3%），急性肝衰竭16例（2.2%）。通过多因素分析，年龄≥40岁（比值比[OR]2.63，p=0.024）和凝血酶原时间（PT）峰值（国际标准化比值[INR]）≥1.5（OR 5.81，p=0.035）被发现是胆汁淤积延长的显著危险因素。年龄≥40岁（OR 5.24，p=0.002）和女性（OR 3.11，p=0.036）是急性肾损伤的显著危险因素。年龄≥40岁（OR 6.91，p=0.002）、HBsAg阳性（OR 5.02，p=0.049）和总胆红素峰值（OR 1.11，p=0.001）是急性肝衰竭的显著危险因素。
年龄≥40岁、女性、HBsAg阳性、PT峰值（INR）≥1.5和总胆红素峰值是急性HAV感染严重并发症的显著危险因素。
