The etiological classification of viral hepatitis, which has been recognized as five types of hepatitis A, B, C, D, and E, respectively written as HAV, HBV, HCV, HDV, HEV, except for hepatitis B virus, which is DNA Except for the virus, the rest are RNA viruses. Hepatitis has been reported, but the isolation of the pathogen has not been successful so far. In recent years, it has been reported that the relationship between hepatitis G virus belonging to flavivirus and TTV of single-stranded DNA and human hepatitis is still controversial.

Parson Russell Terrier

1. Acute hepatitis

It can be divided into acute jaundice hepatitis and acute anicteric hepatitis, and the incubation period is between 15 and 45 days , an average of 25 days, the total duration of 2 to 4 months.

(1) In the early stage of jaundice, there are chills, fever, fatigue, loss of appetite, nausea, oil loathing, abdominal discomfort, pain in the liver area, and gradually darkening of urine color. This period lasts for an average of 5 to 7 days.

(2) During the jaundice stage, the fever subsided, the sclera and skin were yellowed, the jaundice appeared and the subjective symptoms improved, the liver enlargement was accompanied by tenderness and percussion pain, and some patients had mild spleen enlargement. week.

(3) During the recovery period, the jaundice gradually subsided, the symptoms were relieved or even disappeared, the liver and spleen returned to normal, and the liver function gradually recovered. This period lasted from 2 weeks to 4 months, with an average of 1 month.

2. Chronic hepatitis

Have a history of hepatitis B, C, D or HBsAg carrier or acute hepatitis for more than 6 months, and There are still hepatitis symptoms, signs and abnormal liver function, can be diagnosed as chronic hepatitis. Common symptoms are fatigue, general malaise, loss of appetite, liver discomfort or pain, abdominal distension, low-grade fever, and signs are dull complexion, yellow sclera, possible spider mole or liver palm, large liver, medium texture Or fullness, percussion pain, severe splenomegaly, may have deepening jaundice, ascites, lower extremity edema, bleeding tendency and hepatic encephalopathy. According to the degree of liver damage, it can be divided into:

(1 ) Mild patients with mild disease, insignificant symptoms or with only 1 or 2 mild abnormalities in biochemical indicators although there are symptoms and signs.

(2) Moderate symptoms and signs, between mild and severe. Abnormal changes in liver function.

(3) Severe obvious or persistent hepatitis symptoms, such as fatigue, anorexia, abdominal distension, loose stools, etc., may be accompanied by liver disease, liver palms, spider nevus or hepatosplenomegaly, and excluded Other causes and no portal hypertension. Laboratory examination of serum, repeated or persistent elevation of alanine aminotransferase: decreased albumin or abnormal A/G ratio, significantly increased gamma globulin, albumin32g/L, bilirubin 85.5mol/L, coagulation The zymogen activity is 60% to 40%, and one of the three tests can be diagnosed as severe chronic hepatitis.

3. Severe hepatitis

(1) Acute severe hepatitis has rapid onset, rapid progression, deep jaundice, and small liver. Within 10 days after the onset of the disease, neuropsychiatric symptoms appear rapidly, the bleeding tendency is obvious, and liver odor, ascites, hepatorenal syndrome, prothrombin activity less than 40% and other causes are excluded, low cholesterol, liver function Obviously abnormal.

(2) 10 days after the onset of subacute severe hepatitis, there are still extreme fatigue, anorexia, severe jaundice (bilirubin>171mol/L), abdominal distension and ascites formation, and more There is obvious bleeding, generally the liver shrinks and is not prominent, and hepatic encephalopathy is more common in the later stage with severe liver function damage: serum ALT is increased or not significantly increased, while total bilirubin is significantly increased, namely: bile enzyme separation, A/G ratio Inversion, increased gamma globulin, prolonged prothrombin time, and prothrombin activity<40%.

(3) Chronic severe hepatitis Patients with chronic hepatitis cirrhosis or a history of hepatitis B surface antigen carrier, imaging, laparoscopy or liver puncture support the manifestation of chronic hepatitis, and those with subacute severe hepatitis Clinical manifestations and laboratory changes were chronic severe hepatitis.

4. Cholestatic hepatitis

The onset is similar to acute jaundice hepatitis, but the subjective symptoms are often mild, with obvious hepatomegaly, skin itching, Light stool color, serum alkaline phosphatase, &gamma;-transpeptidase, and cholesterol were significantly increased, jaundice was deep, bilirubin was mainly increased directly, transaminase increased slightly, prothrombin time and prothrombin activity normal. Mild clinical symptoms and disparity of deep jaundice are characterized.

5. Post-hepatitis cirrhosis

Early liver cirrhosis must be diagnosed by pathology, ultrasound and CT examination, etc. Laparoscopy is the most valuable reference. Clinical diagnosis of liver cirrhosis refers to patients with chronic hepatitis who have manifestations of portal hypertension, such as abdominal wall and esophageal varices, ascites, liver shrinkage, splenomegaly, widening of the portal vein and splenic vein, and other reasons that can cause portal hypertension are excluded. , according to the degree of hepatitis activity is divided into active and static cirrhosis.