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目的 探讨成人巨细胞病毒肝炎的临床特征及巨细胞病毒重叠感染是否为加重慢性重型乙型肝炎肝损害的因素。方法 采用ELISA方法检测抗巨细胞病毒IgM ,对 15例巨细胞病毒肝炎患者与 2 0例急性甲型肝炎患者、13例慢性重型乙型肝炎患者与 2 0例慢性重型乙型肝炎重叠巨细胞病毒感染患者的临床表现和肝功能进行观测比较。结果 巨细胞病毒肝炎患者与急性甲型肝炎比较 :巨细胞病毒肝炎患者胆汁瘀积症状及病毒血症与后者对比存在显著性差异 (P <0 .0 1) ,消化道症状无差异 (P >0 .0 5 )。肝功能比较 :巨细胞病毒肝炎与急性甲型肝炎梗阻性指标存在显著差异 (P <0 .0 1) ,肝实质损害指标无显著性差异 (P >0 .0 5 )。巨细胞病毒重叠感染慢性重型乙肝患者临床表现及肝实质损害指标与慢性重型乙肝患者比较 ,无显著性差异 (P >0 .0 5 )。结论 巨细胞病毒肝炎患者以急性瘀胆型肝炎表现为主 ,预后良好 ;巨细胞病毒重叠感染不能加重慢性重型乙肝患者肝损害。
Objective To investigate the clinical characteristics of adult cytomegalovirus hepatitis and cytomegalovirus over-infection whether to aggravate chronic hepatitis B liver damage factors. Methods Anti-cytomegalovirus IgM was detected by ELISA in 15 cases of cytomegalovirus hepatitis and 20 cases of acute hepatitis A. 13 cases of chronic severe hepatitis B and 20 cases of chronic severe hepatitis B cytomegalovirus Infected patients with clinical manifestations and liver function were observed and compared. Results Cytomegalovirus hepatitis patients with acute hepatitis A comparison: cytomegalovirus hepatitis patients with cholestasis symptoms and viremia compared with the latter there was significant difference (P <0 01), no difference in gastrointestinal symptoms (P > 0 .0 5). Comparison of liver function: cytomegalovirus hepatitis and acute hepatitis A obstructive indicators were significantly different (P <0.01), liver parenchymal damage indicators no significant difference (P> 0.05). There was no significant difference between the clinical manifestations of chronic severe hepatitis B patients with cytomegalovirus infection and those with chronic severe hepatitis B (P> 0.05). Conclusions The patients with cytomegalovirus hepatitis are characterized mainly by acute stasis and gallbladder hepatitis, and the prognosis is good. The overlapping infection by cytomegalovirus can not aggravate the liver damage in patients with chronic severe hepatitis B.