【摘要】 目的根据美国《急性肝衰竭的处理》意见分析我国急性重型肝炎的临床特点及治疗措施。方法对23例急性重型肝炎的临床资料进行回顾性分析,包括病因、临床表现、治疗方法和转归。结果23例患者的总病死率为86.21%,其中乙型肝炎病毒(HBV)感染是导致急性重型肝炎的首要原因,其最主要的血清学表现为核心抗体IgM阳性,而HBV DNA呈低水平。急性重型肝炎患者出现肝性脑病后平均死亡时间为(1.94±0.66)d,其存活有赖于肝移植、针对病因治疗。结论急性重型肝炎是病死率极高的疾病之一,其病因谱与西方国家的报道不一致,乙型肝炎病毒引起的急性重型肝炎的发病机制和综合内外科治疗有待于进一步研究。更多还原

【Abstract】 Objective To analyze the clinical characteristics and managements of fulminant hepatitis.Methods We retrospectively analyzed the 23 cases with fulminant hepatitis,including cause of the diseases,clinical manifestation,therapeutic method and prognosis.Results The total mortality of fulminant hepatitis was 86.21% with hepatitis B virus as the leading etiology.The patients with HBV infection presented with anti-HBc-IgM positive and low viral load during the onsets of diseases.In addition,the average time from diagnosis of hepatic encephalopathy to die was 1.94±0.66 days.Those survivors might attribute to liver transplantation and the beneficial specific treatment to etiology.Conclusions Fulminant hepatitis had a high mortality and might be quite different from those reported from western countries.The patients who developing fulminant hepatitis after HBV infection need further concerning on the treatments in our country.更多还原