病毒性肝炎的规范化诊断及治疗新进展(2013.4.8规培).ppt

病毒性肝炎的规范化诊断及治疗新进展 重庆医科大学附属第一医院 提 纲 病毒性肝炎规范化诊断标准 病毒性肝炎规范化治疗研究新进展 乙型肝炎抗病毒治疗 丙型肝炎抗病毒治疗 病毒性肝炎的诊断 临床诊断 病原诊断 病理诊断 临床诊断 急性病毒性肝炎(黄疸型/无黄疸型) 慢性病毒性肝炎（轻/中/重） 重型病毒性肝炎（肝衰竭：急/亚急/慢加急/慢） 肝硬化(代偿/失代偿) 淤胆性肝炎（急/慢） Hepatitis - Disease Terminology Acute hepatitis Short-term hepatitis, during which the body’s immune system clears the virus from the body within 6 months Chronic hepatitis Long-term hepatitis, in which the infection persists beyond 6 months because the body’s immune system cannot clear the virus from the body 几个临床有关的问题 重型肝炎的诊断标准：肝衰竭诊疗指南 肝衰竭及其并发症的处理 慢重肝与慢肝重度的鉴别 Types of Hepatitis（病原诊断） Hepatitis How Do You Acquire It? A Oral via contaminated food or water B Blood/body fluids and mother-to-child C Blood/body fluids and mother-to-child D Blood/body fluids (only found with hepatitis B virus) E Oral via contaminated water G Blood Hepatitis B - Diagnosis Terminology HBV DNA Genetic material of the hepatitis B virus HBeAg Viral protein produced when virus replicates ALT/AST Liver enzymes (proteins)-detected at high levels in blood when liver cells are damaged Histology Liver tissue sample seen under the microscope to assess liver damage 1 2 3 4 HBsAg + + + + HBsAb - - - - HBeAg + - + - HBeAb - + - + HBcAb + + + + HBVDNA + - - + 临床意义 ？ ？ ？ ？ Hepatitis C - Diagnosis Terminology HCV RNA Genetic material of the hepatitis C virus ALT/AST Liver enzymes (proteins)-detected at high levels in blood when liver cells are damaged Histology Liver tissue sample seen under the microscope to assess liver damage Rapid Diagnosis Kit Avai