Abstract:

Objective  To explore the clinical characteristics of schistosome-induced liver disease complicated by hepatitis E in elderly patients.  Methods  Thirty-six senile patients with schistosome-induced liver disease complicated by hepatitis E（the observation group） and 38 senile patients with simple hepatitis E（the control group） were from the First Hospital of Jiaxing City. The blood routine measurements， indicators of liver function and blood coagulation function， serum markers of liver fibrosis， and B-ultrasonic measurements of hepatic portal vein diameter and spleen hilus inside diameter of splenic vein， were analyzed in combination with clinical manifestations， disease course and outcomes.  Results  All the 74 cases had acute onset of hepatitis E. The patients in the observation group had severer conditions， which were prone for aggravation. In this group， the incidences of nausea（91.7%， 33/36）， vomit（88.9%， 32/36） and pruritus（33.3%， 12/36） were all higher than those in the control group（P<0.05）. The levels of average total bilirubin and alanine aminotransferase at admission were （153.22±29.71） mol/L and （705.14±356.55） U/L respectively, in the observation group， significantly higher than those in the control group［（109.89±26.28） mol/L and （485.74±297.49） U/L］（P<0.01）. In contrast， the levels of albumin， prothrombin activity， white blood cell， hemoglobin and platelet at admission were significantly lower in the observation group than in the control（P<0.01）. In addition， the levels of four serum markers of liver fibrosis， i.e， the transparent hyaluronic acid， laminin， type III serum procollagen peptide and type IV collagen， were all significantly higher in the observation group than in the control（P<0.01）. Further， B-ultrasonic measurements of hepatic portal vein diameter and spleen hilus inside diameter of splenic vein in the observation group were （16.56±3.38） mm and （10.28±3.31） mm， significantly higher than those in the control［（14.82±3.48） mm and （8.26±3.27） mm］. The recovery of liver function in the observation group was largely prolonged compared with the control［hospitalization duration， （43.7±7.1） days versus（29.5±5.1） days， P<0.01］.  Conclusion  The elderly patients with schistosome-induced liver disease complicated by hepatitis E show severer liver injury than those with pure hepatitis E， thus needing intensive care and treatment.

Key words: Schistosome liver disease, Hepatitis E, Elderly, Clinical analysis