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目的 通过对了型肝炎病毒（ＨＤＶ）感染的乙型肝炎患者临床特点分析，了解ＨＤＶ感染特征和ＨＤＶ致病机理。方法对合并ＨＤＶ感染的５０７例乙型肝炎患者各临床类型肝炎的发生、预后、临床表现、生物化学指标、肝炎病毒标志物等作统计分析，以２１３例单纯ＨＢＶ感染的乙型肝炎患者作对照。结果ＨＤＶ感染后重型肝炎、肝硬化的发生率和病死率、及发生出血、腹水、并发症和ＡＬＴ反复增高及增高幅度均较ＨＤＶ阴性者高（Ｐ＜０．０１或Ｐ＜０．０５），重度慢性肝炎和重型肝炎患者的生物化学指标异常也较对照组明显（Ｐ＜０．０１）。血清ＨＢｅＡｇ（Ｐ＜０．０１）。急性肝炎、重型肝炎和肝硬化ＨＤＡｇ（＋）、ＨＢｅＡｇ（－）表达高于ＨＤＡｇ、ＨＢｅＡｇ均阳性者（Ｐ＜０．０１或Ｐ＜０．０５）。结论 ＨＤＶ感染后重度慢性肝炎、重型肝炎和肝硬化的发生率高，预后差；ＨＤＶ感染可抑制ＨＢＶ复制或ＨＢｅＡｇ表达；ＨＤＶ的直接细胞毒性作用在急性肝炎中可能起主要致病作用，在合并有ＨＤＶ感染的乙型肝炎患者病情加重、病死率增高和慢性化过程中，ＨＤＶ可能起主要促进作用。
Objective To understand the characteristics of HDV infection and pathogenic mechanism of HDV by analyzing the clinical features of hepatitis B virus (HBV) infected by hepatitis type. Methods The incidence, prognosis, clinical manifestations, biochemical indexes and hepatitis virus markers of 507 patients with hepatitis B complicated with HDV infection were analyzed statistically. Totally 213 HBV-infected patients with hepatitis B . Results The incidence of severe hepatitis, liver cirrhosis and mortality after HDV infection were significantly higher than those with HDV (P <0.01 or P <0.05), and the occurrence of hemorrhage, ascites, complications and ALT recurrences and increases were significantly higher , Severe chronic hepatitis and severe hepatitis in patients with biochemical abnormalities than the control group was significantly (P <0.01). Serum HBeAg (P <0.01). The levels of HDAg (+) and HBeAg (-) in acute hepatitis, severe hepatitis and cirrhosis were higher than those in HDAg and HBeAg (P <0.01 or P <0.05). Conclusions The incidence of severe chronic hepatitis, severe hepatitis and cirrhosis after HDV infection is high, and the prognosis is poor. HDV infection can inhibit HBV replication or HBeAg expression. The direct cytotoxicity of HDV may play a major role in the pathogenesis of acute hepatitis. HDV may play a major role in the progression of hepatitis B patients with HDV infection, increased mortality and chronicity.