Lee H S, Byun J H, Kim C Y
Department of Internal Medicine, Seoul National University College of Medicine, Korea.
J Korean Med Sci. 1990 Sep;5(3):149-54. doi: 10.3346/jkms.1990.5.3.149.
One hundred and sixteen Korean adults with biopsy-proven acute viral hepatitis were studied to determine the etiology and the outcome of the disease using paired sera obtained during acute and convalescent phases. The prevalence of acute viral hepatitis A, B, D and non-A non-B were 3.4%, 60.3%, 0.9% and 35.3%, respectively: hepatitis B virus infection was the most common cause and the hepatitis D virus superinfection was almost negligible. Only eleven (26.8%) of 41 patients with AVH NANB were negative for all serological markers of HBV. The rest (73.2%) were positive for at least one HBV marker: HBsAg was positive in 31.7%. Therefore, the presence of HBV serologic markers in the sera does not exclude the diagnosis of AVH NANB in Korea. In patients with acute viral hepatitis B, 27% remained positive for HBsAg. Chronic hepatitis developed in 12.8% and 17% patients with acute hepatitis B and non-A non-B, respectively. Progression to chronic hepatitis in patients with acute viral hepatitis B and non-A non-B occurred more commonly, although statistically not significant, in male sex and in patients who did not have clinical jaundice during the acute phase and who showed bridging necrosis in their liver biopsies. Age did not influence the progression to chronic hepatitis.
对116例经活检证实为急性病毒性肝炎的韩国成年人进行了研究，利用急性期和恢复期采集的配对血清来确定病因和疾病转归。急性甲型、乙型、丁型和非甲非乙型病毒性肝炎的患病率分别为3.4%、60.3%、0.9%和35.3%：乙型肝炎病毒感染是最常见的病因，丁型肝炎病毒重叠感染几乎可以忽略不计。41例非甲非乙型急性病毒性肝炎患者中，只有11例（26.8%）所有乙肝血清学标志物均为阴性。其余患者（73.2%）至少有一种乙肝标志物呈阳性：乙肝表面抗原阳性率为31.7%。因此，韩国患者血清中乙肝血清学标志物的存在并不能排除非甲非乙型急性病毒性肝炎的诊断。在急性乙型病毒性肝炎患者中，27%的患者乙肝表面抗原仍为阳性。急性乙型肝炎和非甲非乙型肝炎患者分别有12.8%和17%发展为慢性肝炎。急性乙型病毒性肝炎和非甲非乙型肝炎患者进展为慢性肝炎在男性以及急性期无临床黄疸且肝活检显示桥接坏死的患者中更为常见，尽管在统计学上无显著差异。年龄不影响向慢性肝炎的进展。
