1212例甲型病毒性肝炎转归的研究

1988年1～4月本市发生甲型病毒性肝炎(下简甲肝)的暴发流行。为了对甲肝患者的预后和转归有一科学的依据,我们对本院所属18个劳保工厂和本院职工患甲肝的1212例进行3年的前瞻性随访     

甲型病毒性肝炎100例实验室检查分析

<正> 1988年1～4月上海市甲型病毒性肝炎暴发流行。我院收治确诊为甲型肝炎患者一百人,就其实验室检查结果分析报道如下。一、一般情况本组甲型病毒性肝炎(以下简称甲肝)的诊断依据是,在甲肝流行期间食有污染毛蚶史或有与急性甲肝病人密切接触史;发病在流行期,有发烧、恶心、呕吐等消化道症状和黄疸;SGPT明显升高和抗HAV—IgM     

惠东县散发性急性病毒性肝炎的血清流行病学分析

目的 :探讨广东惠东县急性病毒性肝炎的血清流行病学特征。方法 :对 5 5 5例急性病毒性肝炎的病原学分型和流行病学特点进行综合分析。结果 :5 5 5例中 ,甲、乙、丙、戊型分别占 3 9.5 %、40 .5 %、7.9%、9.9% ,青少年组甲肝、乙肝、秋季 (9～ 11月 )发病人数分别为 87.6%、3 4.7%、3 0 .6%。结论 :甲肝和乙肝为近年来本县急性病毒性肝炎的最常见类型 ,而青少年组在此占的发病率较高     

驻陕某部队1995—1997年病毒性肝炎发病调查与分析

目的 了解部队病毒性肝炎的实际发病水平和流行特点。方法 调查驻陕某部队防疫所及该部医院传染科１９９５￣１９９７年３ａ期间疫情报卡、传染病报告表达及病毒性肝炎患者的病历,并深入连队对各连登记在案的患者逐例核实,同时调查未登记病例。结果：观察部队３５５４３人中,共发现美丽性肝炎９８例,年平均发病率为２７５．７／１０万,其中甲肝２７例,乙肝４１例,非甲非乙型或未分型３０例,该部３ａ平均漏报率为５５．１％     

急性甲型病毒性肝炎并发严重造血系统损害三例报告

乙型病毒性肝炎并发造血系统损害的报道屡见不鲜,但甲型病毒性肝炎(甲肝)引起严重造血系统损害极罕见,现将我院于1988年2月至3月上海甲肝大流行期间收治的2例甲肝并发急性单纯红细胞再生障碍性贫血(Pure red cell aplasia,纯红再障)、1例甲肝并发血小板减少紫癜报告如下。     

部队急性病毒性肝炎发病前瞻性研究

目的　查明部队人群急性病毒性肝炎真实年发病率 .方法　前瞻性研究 ,观察抽样部队 1a内病毒性肝炎发生情况 .结果　共观察 16 0 36 0人 ,发生病毒性肝炎 310人 ,年发病率为 193.3/ 10万 ,甲肝年发病率 10 0 .4/ 10万 ,乙肝年发病率为 5 7.4/ 10万 .干部病毒性肝炎年发病率 (30 9.6 / 10万 )远高于战士 (173.6 / 10万 ,P<0 .0 1) ,干部乙肝年发病率(12 4.7/ 10万 )也高于战士 (4 6 .0 / 10万 ,P<0 .0 1) ,新兵甲肝年发病率 (130 .6 / 10万 )高于老兵 (81.0 / 10万 ,P<0 .0 1) .结论　部队人群病毒性肝炎年发病率仍很高 .在部队中 ,乙肝预防的重点是干部 ,甲肝预防的重点是新兵 .我们建议应加强部队病毒性肝炎预防策略的研究 ,降低其发病率     

格林—巴利综合征与甲型病毒性肝炎

1988年春上海市暴发食源性甲型病毒性肝炎(以下简称甲肝)流行,本次流行的甲肝特征之一为肝外表现者较多。作者见有3例甲肝患者并发格林一巴利综合征(Guillain-BarrēSyndrome,GBS)现报道如下。临床资料例1 徐××,男,26岁,1988因食毛     

毕节市5起甲型病毒性肝炎暴发疫情分析

目的分析甲型病毒性肝炎暴发疫情的流行特征和现场处置情况,为预防甲肝暴发疫情的发生和提高应急处置能力提供建议。方法根据传染病报告信息管理系统数据和流行病学调查资料,对2007-2010年毕节市5起甲肝暴发疫情进行描述流行病学分析。结果 5起甲肝暴发疫情共报告病例1 937例,占全市总报告病例的47.24%。病例主要集中在19岁以下人群,职业以学生和散居儿童为主。疫情主要发生在旱灾期间或暴雨之后,均与水源污染有关。1起疫情由乡卫生院报告后发现,另外4起疫情由市级以上疾控中心预警后发现。流行时间最短19 d、最长182 d。5起疫情均采取控制传染源、切断传播途径和保护易感人群等综合防控措施。结论疫情的发现和处置不及时是甲肝暴发疫情扩散、蔓延的主要原因,应加强疫情动态监测,及时发现和识别甲肝疫情异常情况并采取强有力的控制措施。     

惠东县散发急性病毒性肝炎的血清流行病学分析

目的：探讨广东惠东县急性病毒性肝炎的血清流行病学特征。方法：对555例急性病毒性肝炎的病原学分型和流行病学特点进行综合分析。结果：555例中，甲、乙、丙、戊型分别占39.5%,40.5%,7.9%,9.9%，青少年组甲肝，乙肝，秋季（9-11月）发病人数分别为87.6%,34.7%,30.6%。结论：甲肝和乙肝为近年来本县急性病毒性肝炎的最常见类型。而青少年组在此占的发病率较高。     

甲型病毒性肝炎心脏损害54例临床分析

1988年1～6月,本市甲肝暴发流行期间,将我院收治的1400例病毒性肝炎患者常规进行心电图(EKG)检查,结果在确诊甲肝的1316例中,排除其他原因所致心脏损害而有EKG异常的54例进行了较为系统的临床观察,现将结果报道如下:     

甲型肝炎早期实验诊断的研究

以人胚肺二倍体细胞分离出的甲型肝炎病毒作抗原,以马抗人IgM经纯化后的抗体为捕捉抗体,以纯化甲型肝炎恢复血清为特异性抗体,过碘酸钠法标记酶,以OPD为底物制成抗-HAV IgM诊断试剂盒,建立了ELISA捕捉法检测抗-HAV IgM,结果:甲型肝炎暴发点84例均为阳性,流行性出血热及健康成人各30例均为阴性。322例急性黄疸型肝炎住院患者中192例阳性(占59.6%)。12例第一病日患者11例阳性(占91.6%),证明该方法对甲型肝炎早期诊断有重要价值。     

Use of IgM-hepatitis A antibody testing. Investigating a common-source, food borne outbreak

An outbreak of hepatitis, type A, affecting 30 employees of a large metropolitan department store was investigated using traditional case findings, a food preference questionnaire, and case-control methods. In addition, the new serological tests for IgM and IgG antibody to hepatitis A virus (anti-HAV) were employed to establish a serological diagnosis of hepatitis A infection, to define the control group, and to identify the index case, an asymptomatic food handler. Twenty-five of 25 cases tested had IgM anti-HAV, whereas none of 73 controls and one of 46 food handlers were IgM anti-HAV positive. This test eliminated three suspect cases that were diagnosed as hepatitis but that had atypical epidemiologic features. Epidemiologic and serological analysis confirmed the association of illness with eating in the employees' cafeteria and eating cold sandwiches.     

重型病毒性肝炎的血清病原学研究

为了解重型病毒性肝炎（重肝）的病原分型及其与预后的关系，应用酶联免疫法对120例重肝患者进行了甲型肝炎病毒抗体（抗-HAV）IgM、HBV标志（HBVM）、丙型肝炎病毒抗体（抗-HCV）的检测。结果显示：抗HAV－IgM阳性19例（15．8％）；HBVM阳性90例（75．0％）；抗-HCV阳性29例（24．2％），其中19例合并HBV感染，单纯抗-HCV阳性6例；三型病毒标志阴性者16例（13．3％）。乙型重肝较甲型重肝、丙型重肝病死率高。慢性重肝、急性重肝较亚急性重肝预后差。HBV复制标志阳性患者预后较差。提示HBV是本地区重肝的主要病原，且预后较差。     

以RFIL消除慢性乙型肝炎血清RF致的抗HAV-IgM假阳性反应

为了解HAV/HBV双重感染的发生情况,作者检测了121例慢性乙型肝炎患者血清抗HAV-IgM,其中经类风湿因子免疫胶乳(RFIL)处理后抗HAV-IgM仍阳性的7例,未经处理的12例阳性,有5例为假阳性,占41.7％(5/12)。用RFIL能消除因血清中RF所致的抗HAV-IgM假阳性反应,不出现假阴性结果。认为RFIL中和反应是一种简单,经济而有效的排除RF干扰的方法。本组慢性乙型肝炎患者重叠感染甲肝病毒7例,占5.8％,均为慢性活动性肝炎。     

部队人群急性散发性戊型肝炎流行病学特征

调查部队人群急性散发性戊型肝炎发病率和分布。方法１９９３－０１／１２地东、西南、华南野战部队以整群抽样的方式前瞻性地观察了１６０３６０人,对散发性戊肝发病情况进行了调查,收集血清,同抗－ＨＥＶＩｇＭ与抗－ＨＥＶＩｇＧ。结论部队人群普遍存在散发性戊肝,应重视期预防。     

Revisiting the Holy Cross football team hepatitis outbreak (1969) by serological analysis

Clinical and biochemical data collected during the Holy Cross College football team hepatitis A outbreak in 1969 suggested that 32 team members had icteric hepatitis, 58 had anicteric illness, and only seven were not infected. Using a currently available radioimmunoassay, we tested stored serum samples obtained during the outbreak for IgM antibody to hepatitis A virus (IgM anti-HAV). Only individuals with icteric hepatitis were found to have IgM anti-HAV in serum; those with presumed anicteric illness were shown not to be infected with hepatitis A virus. The attack rate was thus only 34%, not 93% as originally reported, and the incidence of icteric illness in those infected was 100%, not 33%. This serological analysis of a classic outbreak of hepatitis A illustrates the utility and importance of IgM anti-HAV testing in seroepidemiologic investigations of hepatitis outbreaks.     

STRAIN OF HEPATITIS A VIRUS CAUSING CYTOPATHIC EFFECTS ISOLATED IN A549 CELL LINE

A strain (named BJ-1) of hepatitis A virus (HAV) causing cytopathic effects (CPE) has been isolated in A549 cell cultures from a fecal specimen of an infant with hepatitis A. Hepatitis A antigen (HAAg) w3s detectable in about 50To of the cells by immunofluo- rescence (IF) assay. The viral antigenicity was spe- cifically identified by monoclonal anti-HAV and chim- panzee reference antiserum to HAV (NIH). HAV particles in crystal arraDgement were observed in cell cytoplasm by electron microscopy in ultrathin sec tions. The particles appeared both "empty" and "full". It was observed that many 27-30 nm virtts particles were aggregated by convalescent human he- patitis A sera and chimpanzee HAV antisera observ- ed by immune electron microscopic (IEM) ex- amination. BJ-1 HAAg could be detected on day 34 after inoculation at the initial passage. The virus titers increased and the virus replication cycle short- ened with serial passages. The highest TCID 50 was 10-5/0.1 ml and the shortest replication cycle 2-3 days. IF kit consisting of BJ-1 HAV infected A549 coverslip culture and sheep fluorescence antibody to human IgM were made to detect anti-HAV IgM. Comparing the BJ-t IF with the Abbott EIA HAVAB- M kit. the coincidence rate was 98.4% (246/250).     

Posttransfusion hepatitis type A

Hepatitis A virus (HAV) transmission through blood is a rare but potential cause of posttransfusion hepatitis. We can now document such a case supported by laboratory evidence of HAV in the donor blood. A 10-year-old girl manifested icteric hepatitis A 31 days after receiving a single unit of packed RBCs from a donor who subsequently experienced hepatitis A and died in hepatic failure. Hepatitis A virus antigen was detected in the donor's hepatocytes and in plasma obtained from the original donor unit. The density in cesium chloride of the HAV antigenic activity from the liver and plasma ranged from 1.33 to 1.37 g/cu cm, which is similar to that reported for infectious HAV particles. The implicated donor plasma had normal aminotransferase levels and was negative for antibody to HAV. Inoculation of this plasma into a chimpanzee resulted in the development of hepatitis A 23 days later based on the appearance of fecal HAV antigen, hepatitis, and IgM anti-HAV seroconversion. These data clearly document the presence of HAV in the donor sample that produced posttransfusion hepatitis A.     

病毒性肝炎相关性骨髓抑制：附27例报告

目的：探讨病毒性肝炎对骨髓造血功能的影响。方法：检测肝功能、免疫学、血液学、骨髓象或活检，对２７例肝炎伴骨髓抑制患者，其中１７例再障（ＡＡ），１０例纯红再障（ＰＲＣＡ）进行临床分析。结果：２７例住院患者中急性肝炎１２例，慢性肝炎８例，淤胆型３例，重症型肝炎４例。骨髓抑制属急性２１例、慢性６例．病毒检测示ＨＡＶＩｇＭ：ＡＡ１３／１３例（－），ＰＲＣＡ５／１０例（＋）。ＨＲＶＭ：ＡＡ７／１７例（＋），