传染病Viralhepatitis.pptVIP

* Laboratory examination Ultra-sound examination Liver biopsy Other laboratory examination Blood routine Urine routine * Complication Intrahepatic Cirrhosis, liver cancer, fatty Liver Extrahepatic Diabetes, pancreatitis, infection of biliary tract, hemolytic anemia, aplastic anemia, glomerulo-nephritis, renal tubular acidosis * Complication Hepatitis gravis Upper gastrointestinal hemorrhage Hepatorenal syndromes Hepatic encephalopathy Infection * Diagnosis Epidemiological data HA, HE: food, water, seasonal, age HB, HC: blood or blood product transfusion, contact history, inoculation history（接种史） Clinical diagnosis Acute hepatitis Chronic hepatitis Hepatitis gravis * Diagnosis Etiological diagnosis HA: Serum anti-HAVIgM, Feces HAV HB: HBsAg HBeAg HBcAg anti-HBc HBVDNA DANp HC: anti-HCV IgM IgG HD: HBsAg HDAg anti-HDV HE: anti-HEV IgM IgG HEVRNA HEV particals in feces * Diagnosis：慢性HBV感染 有乙型肝炎或HBsAg阳性史超过6个月，现HBsAg和(或) HBV DNA仍为阳性者，可诊断为慢性HBV感染。 根据HBV感染者的血清学、病毒学、生化学试验及其他临床和辅助检查结果，可将慢性HBV感染分为：慢性乙型肝炎、乙型肝炎肝硬化、携带者和隐匿性慢性乙型肝炎 * Diagnosis：慢性HBV感染 慢性乙型肝炎 HBeAg阳性慢性乙型肝炎 HBsAg、HBV DNA和HBeAg阳性，抗-HBe阴性 ALT持续或反复升高 或肝组织学检查有肝炎病变 HBeAg阴性慢性乙型肝炎 血清HBsAg和HBV DNA阳性，HBeAg持续阴性，抗-HBe阳性或阴性 血清ALT持续或反复异常 或肝组织学检查有肝炎病变 * Diagnosis：慢性HBV感染 携带者 慢性HBV携带者：血清HBsAg和HBV DNA阳性，HBeAg或抗-HBe阳性，1年内连续随访3次以上，血清ALT和AST均在正常范围，肝组织学检查一般无明显异常。对血清HBV DNA阳性者，应动员行肝穿刺检查，以便进一步确诊和进行相应治疗。 非活动性HBsAg携带者：血清HBsAg阳性、HBeAg阴性、抗-HBe阳性或阴性，HBV DNA检测不到或低于最低检测限，1年内连续随访3次以上，ALT均在正常范围，肝组织学检查显示病变轻微。 * Differential diagnosis Jaundice caused by another disease Hemolytic jaundice Extrahepatic obstructive jaundice Hepatitis caused by another reasons Other virus hepatitis: EBV, CMV Toxic hepatitis Infective hepatitis Drug hepatitis Alcohol hepatic disease Wilson disease Connective tissue disease, autoimmune hepatitis * Treatment Acute hepatitis Isolation HA: 3 weeks after onset HB: HBsAg become negative HC: HCVRNA become negative HE: 2 weeks after onset Rest, Diet Hepatoprotection therapy Ant