[Comparative study on clinical features of 215 patients with acute and subacute severe hepatitis.]

To analyze the clinical features of acute severe hepatitis (ASH) and subacute severe hepatitis (SSH) by comparison analysis.

The clinical features of 215 cases with ASH and SSH from 1995 to 2005 were retrospectively analyzed by using chi-test, t-test and regression analysis.

The most common cause of ASH or SSH was hepatitis B virus (HBV) infection (>30%). Anti-tuberculosis therapy was the main cause of drug-induced ASH or SSH. The incidences of hepatic encephalopathy were 78.13% and 43.05% respectively (P less than 0.001). Prothrombin activity was less than 20% and less than 30%, respectively in cases with ASH and SSH. The most common complications of ASH were hepatic encephalopathy, imbalance of electrolyte and cerebral edema, and that of SSH were ascites, imbalance of electrolyte and hepatic encephalopathy. Prothrombin time, ratio of WBC and neutrophil count were positively related to case fatality of ASH or SSH. Prothrombin activity and total cholesterol (TC) were negatively correlated with fatality of ASH or SSH. Total bilirubin, blood ammonia and creatinine were also positively correlated with fatality of SSH; chlolinesterase, triglyceride, PLT, albumin were negatively correlated with fatality of SSH.

ASH and SSH are two different entities because of obvious differences in the ages of suffering, the incidence and occurring time of hepatic encephalopathy, abnormality of function of blood coagulation and the marker for predicting prognosis. Severe abnormality of function of blood coagulation is an important marker with high sensitivity and specificity in ASH or SSH patients without hepatic encephalopathy.