摘要
目的观察分析成人急性乙型肝炎（AHB）的流行特点及临床特征，探讨成人HBV感染的防治策略。方法以120例住院的成人AHB患者为研究对象，采取病区及电话预约门诊随访的方法，调查收集患者的流行病学资料，动态观察AHB临床特点与流行规律。结果流行病学：①性别与年龄：男女比例为3：1，发病高峰男性为30～50岁，女性为18～30岁，男女平均年龄相比差异具有统计学意义（P〈0．01）；②职业构成：商业服务人员占24％，工人22％，管理人员18％，技术与文职人员17％，无业人员9％，农渔民7％，学生3％；③暴露因素：可能经性途径传播的26．7％，非正规医院注射、口腔就医、微创手术、有创美容、修脚、针灸、共用剃须刀、吸毒等分别占5．0％、5．0％、3．3％、3．3％、3．3％、2．5％、0．8％，0.8％，其中49．2％的患者暴露因素不详；④发病时间：无明显季节差别。临床特征：①疾病谱以黄疸型为主，占93．3％；②一过性急性肝损伤，入院时平均ALT水平为1578IU／L，ALT平均恢复正常的时间为（19．99±5．63）d；③未经抗病毒治疗均顺利恢复健康。结论密切接触，尤其是性接触为目前成人散发性急性HBV感染的主要传播方式。医源性传播途径仍是HBV感染的重要暴露因素，但仍有近半数感染途径不明。不同性别、不同职业暴露HBV的风险不同。黄疸型为主的疾病谱及一过性肝损伤的良性经过是AHB较鲜明的临床特征。
Objective To study the mechanisms of viral clearance and hepatic injmy of acute hepatitis B（AHB） and the strategy of prevention and treatment of AHB by analysis of the epidemic character, etiology and clinical feature of adult AHB. Methods 120 hospitalized adult patients with AHB were investigated. Epidemiological and clinical data were collected from the case history records or face-to-face inquiry, and sermn samples during hospitalization and 42 weeks to 5 years follow-up were collected to detect the HBV serum marker by ELISA and the HBV genotype by real-time PCR. Results Epidemiology： ①Sex and age distribution： the ratio of male to female patients was 3 ： 1. The age of most male patients with AHB ranged from 30 to 50 years, while most of female patients ranged from 18 to 30 years. The mean age of males was significantly higher than that of females. ②Professions： the percentage of commercial servers, workers, managers, technicians, unemployed men, farmers and students were 24%, 22%, 18%, 17%, 9%, 7%, 3% respectively.③Exposure factors associated with AHB： the passible exposure factors associated with AHB in these patients included sex intercourse （26.7%）, stomatological treatment（5.0% ）, injection（5.0% ）, minimally invasive operation （3.3 % ）, illegal facial surgery （ 3.3 % ）, pedicure （ 3.3 % ）, acupuncture （ 2.5 % ）, shaving （ 0. 8 % ） and drug abuse （0.8%）, while no definite exposure factors were found in the remaining patients （49.2%）. ④Season distribution： no statistical difference was found in the incidence of AHB between different seasons. Clinical characteristics： ① Jaundice was observed among 93.3% of all AHB patients.② The median senan ALT level of patients with AHB was 1578 IU/L on admission, and the average normalization time of serum ALT was （ 19.99 ± 5.63）days. ③All of the patients recovered from AHB without antiviral treatment. Conclusions Frequent touch with patients suffering from HBV infection, especially sex intercour
出处
《国际流行病学传染病学杂志》
CAS
2009年第4期223-226,共4页
International Journal of Epidemiology and Infectious Disease
基金
中国博士后科学基金（2005037462）
关键词
肝炎
乙型
临床特征
流行病学
Hepatitis B
Clinical feature
Epidemiology
