实用肝脏病杂志 ›› 2011, Vol. 14 ›› Issue (1): 21-22.doi: 10.3969/j.issn.1672-5069.2011.01.007

• 论著 • 上一篇    下一篇

37例急性乙型肝炎患者临床和病毒学变化特征分析

孙颖,滕光菊,邹正升,李保森   

  1. 100039 北京市 解放军第302医院非感染肝病诊疗中心
  • 收稿日期:2010-08-06 出版日期:2011-02-10 发布日期:2016-04-15
  • 通讯作者: 李保森,E-mail: libaosen16@sina.com
  • 作者简介:孙颖 女,36岁,医学博士,主治医师。主要从事病毒性肝炎及非感染性肝病的发病机制、诊断与治疗学研究 。E-mail:sunying302@yahoo.com.cn

Clinical and virological characteristics of acute hepatitis B: an analysis of 37 cases

SUN Ying,TENG Guangju,ZOU Zhengsheng,et al.   

  1. Department of Non-infectious Liver Diseases,302nd Hospital,Beijing 100039
  • Received:2010-08-06 Online:2011-02-10 Published:2016-04-15

摘要: 目的 探讨急性乙型肝炎患者的临床和病毒学变化特征。方法 对37例急性乙型肝炎患者进行血清和肝组织HBV标志物监测,并随访临床转归。结果 37例急性乙型肝炎患者入院时ALT水平为1143.64±698.32U/L,TBIL为83.99±80.44μmol/L;肝功能恢复正常时间为44.41±15.43天;血清HBsAg转阴时间为55.9±44.3天,HBV DNA转阴时间为39.4±25.2天;发病后6个月时患者HBsAg转阴率为91.9%,3例(8.1%)患者发展为慢性乙型肝炎,均已使用核苷类药物抗病毒治疗;在发病后45天内完成肝穿刺检查。结果显示,肝组织HBsAg转阴时间为22.6±10.0天,阴转率为51.4%;肝组织HBcAg转阴时间为29.8±16.5天,阴转率为73.0%。结论 绝大多数急性乙型肝炎患者均可清除血液及肝细胞内的病毒,使病情得到较快的恢复,而发病初期病毒载量可能对患者预后具有重要的影响。

关键词: 急性乙型肝炎, 临床特征, HBV标志物, 病毒清除

Abstract: Objective To investigate the clinical and virological characteristics of acute hepatitis B. Methods 37 patients with acute hepatitis B were studied for clinical outcomes and their serum and liver HBV markers were detected. Results On admission,serum alanine aminotransferase in the 37 patients with acute hepatitis B were 1143.64±698.32 U/L,and total billirubin were 83.99±80.44μmol/L;and the normalization of liver function was achieved at 44.41±15.43d;3(8.1%)became chronic carriers,and they were all treated with nucleoside analogues;HBsAg in the 37 patients disappeared at 55.9±44.3d,and HBV DNA at 39.4±25.2d;The results of liver biopsy showed that HBsAg disappeared in 22.6±10.0d with the HBsAg loss rate of 51.4%,and HBcAg disappeared in 29.8±16.5d with the HBcAg loss rate of 73%. Conclusions Most patients with acute hepatitis B recovers with viral clearance. The HBV load at onset maybe predict the outcome of acute hepatitis B.

Key words: Hepatitis B, Clinical features, Viral clearance, Prognosis