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由爱泼斯坦-巴尔病毒和巨细胞病毒引起的肝炎:临床特征与转归

Hepatitis due to Epstein-Barr virus and cytomegalovirus: clinical features and outcomes.

作者信息

Leonardsson Hilmar, Hreinsson Jóhann Páll, Löve Arthur, Björnsson Einar S

机构信息

a Faculty of Medicine , University of Iceland, Landspitali, The National University Hospital of Iceland , Reykjavík , Iceland.

b Division of Gastroenterology and Hepatology , Landspitali, The National University Hospital of Iceland , Reykjavík , Iceland.

出版信息

Scand J Gastroenterol. 2017 Aug;52(8):893-897. doi: 10.1080/00365521.2017.1319972. Epub 2017 Apr 27.

Abstract

OBJECTIVE

To determine the frequency of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) hepatitis among those with acute CMV and EBV infection in a population based setting and to compare these two types of hepatitis and analyze the outcomes.

METHODS

A retrospective search was undertaken on all patients with IgM antibodies to CMV and EBV during the period of 2006-2015 in the virological database of the University Hospital of Iceland covering the metropolitan area of Reykjavík (population 202,255). Patients with available liver tests at the University Hospital and/or admitted to this institution were included and relevant clinical data obtained from medical records.

RESULT

Overall, 190 patients had acute EBV infection during the study period and 118 patients were diagnosed with acute CMV. Overall, 82% of patients with acute EBV infection had hepatitis, males 43%, median age 17 years, 15% had jaundice and 26% hospitalized. Among those with acute CMV infection, 69% had elevated liver tests, 63% males, median age 33 years, 9% had jaundice and also 26% hospitalized. Overall, 17% of those with CMV hepatitis were immunosuppressed, 6% were pregnant and 4% developed Guillain-Barré syndrome following the infection.

CONCLUSION

A high proportion of patients with acute CMV and EBV developed hepatitis and jaundice, most of those patients have good prognosis. Patients with CMV hepatitis were more often immunosuppressed, required hospitalization or were pregnant in comparison with patients with EBV hepatitis.

摘要

目的

在基于人群的研究中确定巨细胞病毒(CMV)和EB病毒(EBV)急性感染患者中CMV和EBV肝炎的发生率,比较这两种类型的肝炎并分析其转归。

方法

对冰岛大学医院病毒学数据库中2006年至2015年期间所有CMV和EBV IgM抗体阳性患者进行回顾性检索,该数据库覆盖雷克雅未克市区(人口202,255)。纳入在大学医院进行过肝脏检查和/或入院治疗的患者,并从病历中获取相关临床资料。

结果

总体而言,研究期间190例患者发生急性EBV感染,118例患者被诊断为急性CMV感染。总体而言,82%的急性EBV感染患者发生肝炎,男性占43%,中位年龄17岁,15%出现黄疸,26%住院治疗。在急性CMV感染患者中,69%肝功能检查异常,男性占63%,中位年龄33岁,9%出现黄疸,同样26%住院治疗。总体而言,CMV肝炎患者中17%存在免疫抑制,6%为孕妇,4%在感染后发生吉兰-巴雷综合征。

结论

急性CMV和EBV感染患者中很大一部分发生肝炎和黄疸,大多数患者预后良好。与EBV肝炎患者相比,CMV肝炎患者更常出现免疫抑制、需要住院治疗或为孕妇。

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