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[新疆地区某单中心乙肝病毒感染患者中丁型肝炎病毒感染的血清流行病学特征]

[Sero-epidemiological characteristics of the hepatitis D virus infection among hepatitis B virus infected-patients at a single center in Xinjiang region].

作者信息

Zheng R J, Talafu Tangnuer, Deng Z R, Han D, Pan K J, Lu X B

机构信息

Infectious Diseases and Hepatology Department of the First Affiliated Hospital of Xinjiang Medical University, Xinjiang Infectious Disease (Viral Hepatitis) Clinical Medical Research Center, Urumqi 830000, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2022 Oct 20;30(10):1044-1049. doi: 10.3760/cma.j.cn501113-20220406-00169.

Abstract

To investigate the sero-epidemiological characteristics of the hepatitis D virus (HDV) infection among hepatitis B virus (HBV)-infected patients in Xinjiang region. A single-center cross-sectional analysis method was used to select 264 cases of hepatitis B virus infection who were hospitalized in the Center for Infectious Diseases and Liver Diseases of the First Affiliated Hospital of Xinjiang Medical University from August 2021 to January 2022. All patients were tested for HDV Ag, HDV IgM, HDV IgG, and HDV RNA. The infection status of hepatitis D virus was analyzed by grouping according to their clinical type, HBV viral load, and HBsAg level. A paired t-test was used for data with measurement data conforming to normal distribution. A paired rank sum test was used for data that did not conform to normal distribution before and after treatment. A total of 36 cases (13.64%) and 26 cases (9.85%) were positive for HDV serological markers and HDV RNA. According to clinical type grouping, the positive rates of HDV serum markers in patients with chronic hepatitis B, hepatitis B-related cirrhosis, liver cancer, and liver failure were 13.46%, 12.43%, and 20.83%, respectively, and there was no statistically significant difference among the three groups (=0.86, =0.649). The positive rates of HDV RNA were 11.54%, 8.11%, and 20.83%, respectively, and there was no statistically significant difference among the three groups (=4.015, =0.134). According to HBV viral load grouping, the positive rates of HDV serum markers among patients with viral loads <20, 20-2 000, and >2 000 IU/ml were 17.15%, 7.81%, and 6.67%, respectively, and the difference was not statistically significant among the three groups (=4.846, =0.089). The positive rates of HDV RNA were 9.47%, 10.94%, and 10%, respectively, and the difference was not statistically significant among the three groups (=0.113, =0.945). According to HBsAg level grouping, the positive rates of HDV serum markers in HBsAg<0.05, 0.05~250, and >250 IU/ml were 14.29%, 16.67%, and 10.85%, respectively, and there was no statistically significance between the three groups (=1.745, =0.418). The positive rates of HDV RNA were 4.76%, 8.77%, and 11.63%, respectively, and there was no statistically significant difference among the three groups (=1.221, =0.543). Clinical outcome, disease course, HBV DNA, serological markers of viral hepatitis, routine blood test, biochemical indicators, coagulation function, and other laboratory indicators were compared between HDV serum marker and/or nucleic acid positive and negative patients, and there was no statistically significant difference (>0.05). The positive rate of HDV serological markers and HDV RNA is 13.64% and 9.85%, respectively, at a single center in the Xinjiang region, and there is still a high HDV infection rate among the HBV-infected patients with low levels of viral load and HBsAg.

摘要

为调查新疆地区乙型肝炎病毒(HBV)感染患者中丁型肝炎病毒(HDV)感染的血清流行病学特征。采用单中心横断面分析方法,选取2021年8月至2022年1月在新疆医科大学第一附属医院传染病与肝病中心住院的264例乙型肝炎病毒感染患者。对所有患者进行HDV抗原、HDV IgM、HDV IgG及HDV RNA检测。根据患者临床类型、HBV病毒载量及HBsAg水平分组,分析丁型肝炎病毒感染状况。对符合正态分布的计量资料采用配对t检验,对治疗前后不符合正态分布的数据采用配对秩和检验。HDV血清学标志物及HDV RNA阳性者分别有36例(13.64%)和26例(9.85%)。按临床类型分组,慢性乙型肝炎、乙型肝炎相关肝硬化、肝癌及肝衰竭患者HDV血清标志物阳性率分别为13.46%、12.43%及20.83%,三组间差异无统计学意义(=0.86,=0.649)。HDV RNA阳性率分别为11.54%、8.11%及20.83%,三组间差异无统计学意义(=4.015,=0.134)。按HBV病毒载量分组,病毒载量<20、20 - 2 000及>2 000 IU/ml患者HDV血清标志物阳性率分别为17.15%、7.81%及6.67%,三组间差异无统计学意义(=4.846,=0.089)。HDV RNA阳性率分别为9.47%、10.94%及10%,三组间差异无统计学意义(=0.113,=0.945)。按HBsAg水平分组,HBsAg<0.05、0.05~250及>250 IU/ml患者HDV血清标志物阳性率分别为14.29%、16.67%及10.85%,三组间差异无统计学意义(=1.745,=0.418)。HDV RNA阳性率分别为4.76%、8.77%及11.63%,三组间差异无统计学意义(=1.221,=0.543)。比较HDV血清标志物和/或核酸阳性与阴性患者的临床结局、病程、HBV DNA、病毒性肝炎血清学标志物、血常规、生化指标、凝血功能等实验室指标,差异无统计学意义(>0.05)。新疆地区某单中心HDV血清学标志物及HDV RNA阳性率分别为13.64%和9.85%,在病毒载量及HBsAg水平较低的HBV感染患者中仍有较高的HDV感染率。

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