摘要：目的：探讨乙型肝炎患者重叠感染戊型肝炎病毒(HEV)的临床特点及对病情转归的影响。方法：采用ELISA法检测甲、乙、丙、丁或戊型肝炎病毒以及乙肝病毒e系统状态，PCR法检测HBV-DNA，同时检测肝功能(TB、ALT、AST、ALB、GLB、PT)。然后随机选择慢性乙肝重叠戊型肝炎与同期单纯慢性乙肝患者各50例分成重叠感染组和对照组，对两组进行临床比较分析。结果：重叠感染组与对照组中谷草转氨酶(AST)与球蛋白(GLB)差异均无显著性(P>0.05)，但总胆红素(TB)、谷丙转氨酶(ALT)、白蛋白(ALB)、凝血酶原时间(PT)、HBeAg阳性率，差异均有显著性(P<0.01)和(P<0.05)。重叠感染组重肝存活率为53%。结论：提示HBV与HEV重叠感染肝细胞损害加重，病情趋向重症化。HBeAg阴性的乙型肝炎病毒可能比HBeAg阳性乙型肝炎病毒更易重叠感染戊型肝炎病毒。重叠后发生重肝存活率相对较高，预后并不一定差。

    关键词： 乙型肝炎； 戊型肝炎病毒； 重叠感染

    The Clinical Features and Prognosis of Chronic Hepatitis B Patients Super-infected with Hepatitis E Virus

    PANG Zeng, et al

    (The Center Hospital of Zhanjiang, Guangdong Zhanjiang 524037, China)

    Abstract： Objective: To explore the clinical features and prognosis of hepatitis B virus (HBV) infected patients super-infected with hepatitis E virus (HBV infected patient super-infected with HEV). Method: Hepatitis A (HAV), hepatitis B (HBV), hepatitis C (HCV), hepatitis D (HDV), hepatitis E (HEV), anti HBe antibody and HBeAg are detected in ELISA, HBV-DNA are detected in PCR, and the biochemical indexes of liver function (including TBILI, ALT, AST, ALB, GLB, PT) are also collected. 50 the simply HBV infected patients are randomly chosen to make one group and 50 HBV infected patients super-infected with HEV are chosen to make another. The analyse the two groups. Result: No significant differences in the level of AST and GLB are found between the two groups (P> 0.05). But the levels of TBILI, ALT, ALB, PT, HBeAg positive rates are significantly different between the two groups (P<0.05 or P<0.01). And the livability of severe hepatitis patient in the group of HBV infected patients super-infected with HEV is 53%. Conclusion: HEV infection in patients with HBV infected will aggravate the liver function. HBV infected patients with HBeAg negative may be more susceptible to HEV than the HBV infected patients with HBeAg positive. The livability of severe hepatitis patients in the group of HBV infected patients super-infected with HEV is relatively high and its prognosis is relatively good. ......