本文選題：血吸蟲性肝病　切入點(diǎn)：戊型肝炎　出處：《中國寄生蟲學(xué)與寄生蟲病雜志》2015年04期

【摘要】：目的探討老年血吸蟲性肝病合并戊型肝炎老年患者的臨床特點(diǎn)。方法將嘉興市第一醫(yī)院36例血吸蟲性肝病合并戊型肝炎老年患者(觀察組)與38例單純戊型肝炎老年患者(對(duì)照組)的血常規(guī)、肝功能、凝血功能和肝纖維化血清學(xué)指標(biāo)檢測結(jié)果,及B超測量肝門靜脈內(nèi)徑和脾門區(qū)脾靜脈內(nèi)徑的結(jié)果,結(jié)合其臨床表現(xiàn)、病程和轉(zhuǎn)歸情況等進(jìn)行分析。結(jié)果 74例老年戊型肝炎均為急性起病。血吸蟲性肝病合并感染戊型肝炎患者,病情重,易重癥化。觀察組患者惡心(91.7%,33/36)、嘔吐(88.9%,32/36)及皮膚瘙癢(33.3%,12/36)等癥狀的發(fā)生率較對(duì)照組患者高(P0.05)。入院時(shí)觀察組的平均總膽紅素(TBIL)和丙氨酸轉(zhuǎn)氨酶(ALT)水平分別為(153.22±29.71)μmol/L和(705.14±356.55)U/L均顯著高于對(duì)照組[分別為(109.89±26.28)μmol/L和(485.74±297.49)U/L](P0.01或P0.05),而白蛋白(ALB)、凝血酶原活動(dòng)度(PTA)、血白細(xì)胞、血紅蛋白和血小板則均顯著低于對(duì)照組(P0.01)。觀察組的4個(gè)肝纖維化血清學(xué)指標(biāo),即透明質(zhì)酸(HA)、層黏連蛋白(LN)、血清Ⅲ型前膠原肽(PⅢ)和Ⅳ型膠原(Ⅳ-C)均顯著高于對(duì)照組(P0.01)。此外,在B超下測量觀察組患者的肝門靜脈內(nèi)徑和脾門區(qū)脾靜脈內(nèi)徑,分別為(16.56±3.38)mm和(10.28±3.31)mm,均顯著大于對(duì)照組[分別為(14.82±3.48)mm和(8.26±3.27)mm](P0.01)。觀察組患者的肝功能恢復(fù)慢,住院時(shí)間[(43.7±7.1)d]較對(duì)照組[(29.5±5.1)d]顯著延長(P0.01)。結(jié)論血吸蟲性肝病合并戊型肝炎的老年患者肝臟損害較單純戊型肝炎老年患者嚴(yán)重,需加強(qiáng)監(jiān)護(hù)與治療。
[Abstract]:Objective to investigate the clinical characteristics of elderly patients with schistosomiasis liver disease and hepatitis E.Methods Blood routine examination and liver function were performed in 36 elderly patients with schistosomiasis liver disease combined with hepatitis E (observation group) and 38 elderly patients with simple hepatitis E (control group) in Jiaxing first Hospital.The results of coagulation function and serum indexes of hepatic fibrosis, the diameter of portal vein of liver and splenic vein in portal area of spleen were measured by B-ultrasound, and the clinical manifestation, course of disease and prognosis were analyzed.Results 74 cases of senile hepatitis E were all acute onset.Schistosomiasis liver disease complicated with hepatitis E infection, the disease is serious, easy to severe.In the observation group, the incidence of nausea (91.7 / 36), vomiting (88.9 / 32 / 36) and pruritus (33.3% / 36) were higher than those in the control group (P 0.05).Hemoglobin and platelet were significantly lower than that of control group (P 0.01).The serum levels of hyaluronic acid (HA), laminin laminin (LNN), serum procollagen 鈪，

本文編號(hào)：1720912