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甲型肝炎

最后审阅: 29 Aug 2024
最后更新: 21 Feb 2024

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
完整详情

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
完整详情

危险因素

  • 生活在地方性流行地区
  • 前往疫区旅行
  • 与感染者密切接触
  • 男男性行为者
  • 已知食源性疾病暴发
  • 使用违禁药物
  • 无家可归
  • 职业暴露
完整详情

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
完整详情

需考虑的检查

  • 抗HAV-IgG抗体
  • 甲肝病毒 RNA 检测
完整详情

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

Doan Y Dao, MD

Assistant Professor of Medicine

Director, Center of Excellence for Liver Disease in Vietnam

Johns Hopkins School of Medicine

Department of Medicine

Division of GI and Hepatology

Baltimore, MD

利益声明

DYD receives grants from Roche, serves as guest director of hepatology for Tech University, and is a member of the Data and Safety Monitoring Board of the IQVIA.

鸣谢

Dr Doan Dao would like to gratefully acknowledge Dr Musaddiq Waheed and the late Dr Fida A. Khan, the previous contributors to this topic.

利益声明

MW and FAK declared that they have 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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