急性乙型肝炎和慢性乙型肝炎病毒感染急性发作鉴别诊断的临床研究

Differential clinical diagnostic parameters of acute hepatitis B and flare of chronic HBV infection

目的 探讨急性乙型肝炎 (急乙肝 )和慢性乙型肝炎病毒感染急性发作 (慢乙肝急性发作 )的鉴别诊断及预防措施。方法 通过比较急乙肝和慢乙肝急性发作患者的临床资料 ,发现有用的鉴别指标。结果 患者入院时血清中HBV DNA定量已经阴转 ;当ALT降至 4 0 0IU L以下时 ,HBV DNA定量阴转或HBsAg阴转或已经发生HBeAg HBeAb转换 ;均可诊断为急乙肝。

Objective To evaluate useful clinical diagnostic parameters for differentiating acute hepatitis B and flare of chronic HBV infection. Methods Using PCR method to detect viral level in the patient’s serum, HBV marker was detected by ELISA kit. Liver function was also detected. Results The patient can be diagnosed as acute hepatitis B if a patient has one of the following parameters: (1)HBV-DNA negative on admission. (2) When the patient’s ALT was lower than 400 IU/L, HBV-DNA was negative or HBsAg became negative or HBeAg/HBeAb seroconverted. Conclusion The viral DNA level, HBV marker and ALT can help differentiate acute hepatitis B and flare of chronic HBV infection.