17例人微小病毒B19肝炎患者临床特点分析

doi:10.3969/j.issn.1672-5069.2014.06.009

摘要/Abstract

摘要： 目的探讨人微小病毒B19肝炎患者的临床特征。方法对17例感染人微小病毒B19患者的病历资料进行回顾性分析,总结肝损害的特点和临床特征。结果17例人微小病毒B19肝炎患者均有发热（100%）,有全身乏力14例（82.4%）、关节、肌肉痛9例（52.9%）、咽痛6例（35.3%）、食欲减退11例（64.7%）、皮疹5例（29.4%）、脾肿大12例（70.6%）,肝肿大7例（41.2%）、淋巴结肿大3例（17.6%）、黄疸5例（29.4%）;除血ALT和AST升高外,伴有羟丁酸脱氢酶、乳酸脱氢酶、腺苷脱氨酶升高和淋巴细胞百分比升高;起病急,临床表现复杂,但多呈急性自限性过程,肝功能恢复较快,预后较好。结论对不明原因肝损害同时伴有上述特征者,除常规筛查常见的嗜肝病毒外,及时检测血清抗人微小病毒B19抗体IgM,能帮助明确一部分患者的病因。

关键词: 人微小病毒B19, 肝损害, 临床特征

Abstract: Objective To summarize the clinical characteristics of patients with human parvovirus B19（HPV） infection. Methods The clinical materials in 17 patients with human parvovirus B19 infection was retrospectively summarized,and the clinical features,laboratory findings and radiologic imaging were analyzed. ResultsThe predominant symptoms and signs of patients in this series were:fever（100.0%）,general fatigue （82.4%）,arthralgia/myalgia （52.9%）,pharyngalgia（17.4%）,anorexia（64.7%）,rash（17.3%）,splenomegaly （70.6%）, hepatomegaly （41.2%）,lymphadenectasis （17.6%） and jaundice （17.3%）;The laboratory findings showed elevated serum alanine aminotransferase and aspartate transferase,lactate dehydrogenase,hydroxybutyrate dehydrogenase and adenosine deaminase levels,and higher lymphocyte counts;Hepatic injury caused by HPV B19 infection had features of acute onset and complicated clinical manifestations, but with a self-limited illness course. The recovery of liver function was rapid and the prognosis was relatively good. ConclusionThe patients who have unexplained hepatic injury should have a prompt detection of serum anti-HPV B19 IgM,especially in those with negative serum hepatitis A,B,C and E virus markers.

Key words: Human parvovirus B19, Viral hepatitis, Clinical features

苏少慧, 胡义亭, 侯洪涛, 刘娜, 王玉珍. 17例人微小病毒B19肝炎患者临床特点分析[J]. 实用肝脏病杂志, 2014, 17(6): 592-595.

Su Shaohui, Hu Yiting, Hou Hongtao. Clinical characteristics of patients with human parvovirus B19 infection: An analysis of 17 cases[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2014, 17(6): 592-595.

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