52例急性戊型肝炎患者临床特征与转归分析*

doi:10.3969/j.issn.1672-5069.2026.01.011

实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (1): 41-44.doi: 10.3969/j.issn.1672-5069.2026.01.011

52例急性戊型肝炎患者临床特征与转归分析^*

吴红, 吕春, 姜正伟, 蒋培莉, 沈兰超

223001 江苏省淮安市第四人民医院肝病科(吴红,吕春,姜正伟,沈兰超);南京医科大学附属淮安第一医院感染病科(蒋培莉)

收稿日期:2024-11-19 出版日期:2026-01-10 发布日期:2026-02-04
通讯作者: 沈兰超,E-mail:15152379780@163.com
作者简介:吴红,女,37岁,大学本科,主治医师。研究方向:病毒性肝炎诊断与治疗研究。E-mail:15298665723@163.com
基金资助:
^*江苏省自然科学基金面上项目(编号:BK20210899)

Clinical feature and prognosis of patients with acute hepatitis E: An analysis of 52 cases

Wu Hong, Lyu Chun, Jiang Zhengwei, et al

Department of Liver Diseases, Fourth People's Hospital, Huai 'an 223001, Jiangsu Province, China

Received:2024-11-19 Online:2026-01-10 Published:2026-02-04

摘要/Abstract

摘要： 目的分析总结一组急性戊型肝炎(AHE)患者的临床特征和预后。方法 2022年1月～2023年12月我院诊治的AHE患者52例,均给予常规护肝退黄治疗,给予肝衰竭患者人工肝支持治疗。结果在52例AHE患者中,典型急性肝炎30例,高胆红素血症17例,肝衰竭5例;高胆红素血症者男性占比、合并脂肪肝、酒精性肝病和住院时间分别为82.3%、47.1%、58.8%和(27.0±6.5)d,均显著高于或长于AHE组【分别为63.3%、10.0%、13.3%和(15.4±3.0)d,P<0.05】;在发病高峰时,高胆红素血症组血清总胆红素(TBIL)水平为(195.8±45.6)μmol/L,显著高于AHE组【(84.7±23.8)μmol/L,P<0.05】;肝衰竭患者血清TBIL、白蛋白和凝血酶原时间国际标准化比值分别为(345.2±66.8)μmol/L、(28.9±8.6)g/L和(2.6±0.9);本组AHE和高胆红素血症患者均预后良好,但5例肝衰竭患者死亡3例(60.0%)。结论 AHE患者容易出现高胆红素血症,尤其在男性合并脂肪肝或/和酒精性肝病患者。部分患者病情可发展至肝衰竭,预后差。

关键词: 急性戊型肝炎, 高胆红素血症, 肝衰竭, 预后

Abstract: Objective The aim of this study was to summarize clinical feature and prognosis of patients with acute hepatitis E(AHE). Methods Fifty-two patients with AHE were encountered in our hospital between January 2022 and December 2023, and were dealt with conventional liver-protecting measures. Patients with liver failure(LF) were carefully treated by artificial liver supporting system (ALSS) and human blood products. Results Of the 52 patients with AHE, typical AHE was found in 30 cases, and those with hyperbilirubinemia in 17 cases and LF in 5 cases; male percentage, concomitant fatty liver, alcoholic liver disease (ALD) and hospital stay in patients with hyperbilirubinemia were 82.3%, 47.1%, 58.8% and (27.0±6.5)d, all much higher or longer than [63.3%, 10.0%, 13.3% and (15.4±3.0)d, respectively, P<0.05] in those withs AHE; peak total serum bilirubin level (TSB) in patients with hyperbilirubinemia was (195.8±45.6)μmol/L, much higher than [(84.7±23.8)μmol/L, P<0.05] in those with AHE; TSB, albumin and prothrombin time international ratio in patients with LF were(345.2±66.8)μmol/L, (28.9±8.6)g/L and (2.6±0.9); all patients, but two (60.0%)with LF died, got a good prognosis in our series. Conclusion Patients with AHE tends to have hyperbilirubinemia, especially in those with fatty liver or ALD, which might lead to death and needs carefully managed clinically.

Key words: Acute hepatitis E, Hyperbilirubinemia, Liver failure, Prognosis

吴红, 吕春, 姜正伟, 蒋培莉, 沈兰超. 52例急性戊型肝炎患者临床特征与转归分析^*[J]. 实用肝脏病杂志, 2026, 29(1): 41-44.

Wu Hong, Lyu Chun, Jiang Zhengwei, et al. Clinical feature and prognosis of patients with acute hepatitis E: An analysis of 52 cases[J]. Journal of Practical Hepatology, 2026, 29(1): 41-44.

参考文献

[1] Aslan AT, Balaban HY. Hepatitis E virus: Epidemiology, diagnosis, clinical manifestations, and treatment. World J Gastroenterol, 2020, 26(37):5543-5560.
[2] Mendizabal M, Haddad L, Marciano S, et al. Hepatitis E infection is an infrequent cause of acute hepatitis in the metropolitan area of Buenos Aires. J Clin Virol, 2020, 126: 104309.
[3] Choi JW, Son HJ, Lee SS, et al. Acute hepatitis E virus superinfection increases mortality in patients with cirrhosis. BMC Infect Dis, 2022, 22(1): 62.
[4] Sayed IM, Abd Elhameed ZA, Abd El-Kareem DM, et al. Hepatitis E virus persistence and/or replication in the peripheral blood mononuclear cells of acute HEV-infected patients. Front Microbiol, 2021, 12: 696680.
[5] Kamar N, Pischke S. Acute and persistent hepatitis E virus genotype 3 and 4 infection: clinical features, pathogenesis, and treatment. Cold Spring Harb Perspect Med, 2019, 9(7):a031872.
[6] 严虹, 向泽, 陈佳琦, 等. 腺苷高半胱氨酸酶在戊型肝炎急性肝衰竭患者预后评估中的价值. 中华检验医学杂志, 2024, 47(8):888-894.
[7] Abravanel F, Pique J, Couturier E, et al. Acute hepatitis E in French patients and neurological manifestations. J Infect, 2018, 77(3): 220-226.
[8] Zachou K, Azariadis K, Sofia M, et al. Acute non-A, non-B, non-C hepatitis differences and similarities between hepatitis E virus infection and autoimmune hepatitis, with phylogenetic analysis of hepatitis E virus in humans and wild boars. Ann Gastroenterol, 2022, 35(5): 532-540.
[9] 吴健, 向泽, 翟光华, 等. 血清氨甲酰磷酸合成酶1在戊型肝炎急性肝衰竭患者的表达及其预后价值. 中华检验医学杂志, 2023, 46(1):62-67.
[10] Lhomme S, Marion O, Abravanel F, et al. Clinical manifestations, pathogenesis and treatment of hepatitis E virus infections. J Clin Med, 2020, 9(2):331.
[11] Wu J, Ling B, Guo N, et al. Immunological manifestations of hepatitis E-associated acute and chronic liver failure and its regulatory mechanisms. Front Med (Lausanne), 2021, 8: 725993.
[12] Paul RC, Nazneen A, Banik KC, et al. Hepatitis E as a cause of adult hospitalization in Bangladesh: Results from an acute jaundice surveillance study in six tertiary hospitals, 2014-2017. PLoS Negl Trop Dis, 2020, 14(1): e0007586.
[13] Dimeglio C, Kania D, Mantono JM, et al. Hepatitis E virus infections among patients with acute febrile jaundice in Burkina Faso. Viruses, 2019, 11(6):554.
[14] Anand AC, Nandi B, Acharya SK, et al. Indian national association for the study of the liver consensus statement on acute liver failure (part 1): epidemiology, pathogenesis, presentation and prognosis. J Clin Exp Hepatol, 2020, 10(4): 339-376.
[15] Zhang S, Chen C, Peng J, et al. Investigation of underlying comorbidities as risk factors for symptomatic human hepatitis E virus infection. Aliment Pharmacol Ther, 2017, 45(5): 701-713.
[16] Li M, Li S, He Q, et al. Hepatitis E-related adverse pregnancy outcomes and their prevention by hepatitis E vaccine in a rabbit model. Emerg Microbes Infect, 2019, 8(1): 1066-1075.
[17] Li P, Li Y, Wang Y, et al. Recapitulating hepatitis E virus-host interactions and facilitating antiviral drug discovery in human liver-derived organoids. Sci Adv, 2022, 8(3): eabj5908.
[18] Terahara K, Li TC, Matsubayashi K, et al. Calibrating hepatitis E virus serological assays using asymptomatic specimens obtained in Japan. Microbiol Spectr, 2022, 10(5): e0214622.
[19] Rivero-Juarez A, Lopez-Lopez P, Pineda JA, et al. Limited value of single sampling for igm antibody determination as a diagnostic approach for acute hepatitis E virus infection. Microbiol Spectr, 2021, 9(1): e0038221.
[20] Dichtl K, Zimmermann J, Koeppel MB, et al. Evaluation of a novel CLIA monotest assay for the detection of anti-hepatitis E Virus-IgG and IgM: a retrospective comparison with a line blot and an ELISA. Pathogens, 2021, 10(6):689.

52例急性戊型肝炎患者临床特征与转归分析^*

Clinical feature and prognosis of patients with acute hepatitis E: An analysis of 52 cases

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