甲型肝炎

最后审阅: 17 四月 2022
最后更新: 01 十月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 发热
  • 不适感
  • 恶心和呕吐
  • 黄疸
  • 肝肿大
  • 右上腹痛
  • 陶土色大便
更多 关键诊断因素

其他诊断因素

  • 疲劳
  • 头痛
  • 小便黄赤
  • 瘙痒
  • 关节痛和肌痛
  • 咳嗽
  • 腹泻
  • 便秘
  • 脾肿大
  • 颈后淋巴结肿大
  • 短暂皮疹
  • 心动过缓
其他诊断因素

危险因素

  • 生活在地方性流行地区
  • 与感染者密切接触
  • 男男性行为者
  • 发达国家人群到甲肝流行地区旅游
  • 注射吸毒者
  • 已知食源性疾病暴发
  • 接触托儿所儿童或工作人员
更多 危险因素

诊断性检查

首要检查

  • 血清氨基转移酶
  • 血清胆红素
  • 血尿素
  • 血清肌酐
  • 凝血酶原时间
  • 抗HAV-IgM抗体
更多 首要检查

需考虑的检查

  • 抗HAV-IgG抗体
  • 电镜检测粪便及体液
  • 甲肝病毒RNA(HAV RNA)检测
更多 需考虑的检查

治疗流程

初步治疗

无疫苗接种史,且近期有甲型肝炎病毒暴露史者(<2周)

急症处理

确诊的甲型肝炎

撰稿人

作者

Musaddiq Waheed, MD

Hospitalist Physician

Archbold Memorial Hospital

Thomasville

GA

Assistant Clinical Professor

Florida State University School of Medicine

Tallahassee

FL

利益声明

MW declares that he has no competing interests.

鸣谢

Dr Muaddiq Waheed would like to gratefully acknowledge the late Dr Fida A. Khan for his contribution to this topic.

利益声明

FAK declared that he has no competing interests.

同行评议者

Howard J. Worman, MD

Professor of Medicine and Cell Biology

Columbia University College of Physicians and Surgeons

New York

NY

利益声明

HJW declares that he has no competing interests.

Srikrishna Nagri, MD

Gastroenterologist

Dartmouth-Hitchcock Nashua

Nashua

NH

利益声明

SN declares that he has no competing interests.

George Y. Wu, MD, PhD

Professor of Medicine

University of Connecticut Health Center

Farmington

CT

利益声明

GYW is on the medical advisory boards of the following: Gilead Sciences, Bristol-Myers Squibb, AbbVie, and Intercept.

Kittichai Promrat, MD

Assistant Professor

Division of Gastroenterology

Department of Medicine

Brown University

RI

利益声明

KP declares that he has no competing interests.

Pierre Van Damme, MD, PhD

Professor

Director of Vaccine & Infectious Disease Institute

University of Antwerp

Antwerp

Belgium

利益声明

PVD has been and still is principal investigator of vaccine trials for several vaccine manufacturing companies, from which the university obtained and obtains research contracts and funds for conducting such vaccine trials.

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