Miao N, Zhang G M, Wang F Z, Zheng H, Sun X J, Ma X J, Cui F Q
National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Qinghai Provincial Center for Disease Control and Prevention, Xining 810007, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Feb 10;38(2):216-220. doi: 10.3760/cma.j.issn.0254-6450.2017.02.016.
To understand the characteristics of acute hepatitis B inpatients reported by the hepatitis B surveillance pilot points and to estimate the consistency between the diagnosed and reported types of hepatitis B by the clinicians involved. Data related to acute hepatitis B was from the NNDRS and the characteristics of acute hepatitis B were classified by querying Hospital Information System. We recorded the results based on clinical diagnosis and analyzed the consistency between the reported and diagnosed types that the clinicians made, on hepatitis B. A total of 179 patients were included in this study with all of them as acute hepatitis B reported through NNDRS in 2015-2016. In terms of the durations of disease, among the 179 cases who were HBsAg positive, 32.40% (58/179) of them exceeding 6 months, 2.79% (5/179) within 6 months and 64.80% (116/179) tested the first time or never. Among the 179 cases who claimed having the history of hepatitis, 33.52% (60/179) of them identified as having hepatitis B, 1.12% (2/179) were hepatitis A, C or E, 41.34% (74/179) did not have the signs on hepatitis, while the rest 24.02% (43/179) did not know the situation. Only 79.89% (143/179) of the patients showed the symptoms or signs of hepatitis, but the rest 20.11% (36/179) did not. Among the 179 reported acute hepatitis patients, 67 of them were diagnosed as acute hepatitis B while 112 cases were as non-acute hepatitis B. The consistent rate of acute hepatitis B was 37.43% (67/179). Among the 112 cases that were diagnosed as non-acute hepatitis B, proportions of chronic hepatitis B and cirrhosis were 49.11%(55/112) and 16.07%(18/112) respectively. Consistency between the reported type of acute hepatitis B inpatients and the types diagnosed by clinicians was poor. Our results suggested that clinicians should make the accurate diagnosis at first place and then report to the Network in accordance with the clinical diagnosis classification criterfia, set by the government.
了解乙肝监测试点地区报告的急性乙肝住院患者的特征，并评估参与的临床医生所诊断和报告的乙肝类型之间的一致性。急性乙肝相关数据来自国家疾病监测信息报告管理系统（NNDRS），通过查询医院信息系统对急性乙肝的特征进行分类。我们根据临床诊断记录结果，并分析临床医生在乙肝报告类型和诊断类型之间的一致性。本研究共纳入179例患者，均为2015 - 2016年通过NNDRS报告的急性乙肝患者。在病程方面，179例HBsAg阳性患者中，病程超过6个月的占32.40%（58/179），6个月内的占2.79%（5/179），首次检测或从未检测过的占64.80%（116/179）。在179例自称有肝炎病史的患者中，33.52%（60/179）被确诊为乙肝，1.12%（2/179）为甲型、丙型或戊型肝炎，41.34%（74/179）无肝炎体征，其余24.02%（43/179）情况不明。仅79.89%（143/179）的患者有肝炎症状或体征，其余20.11%（36/179）没有。在179例报告的急性肝炎患者中，67例被诊断为急性乙肝，112例被诊断为非急性乙肝。急性乙肝的一致率为37.43%（67/179）。在112例被诊断为非急性乙肝的患者中，慢性乙肝和肝硬化的比例分别为49.11%（55/112）和16.07%（18/112）。急性乙肝住院患者报告类型与临床医生诊断类型之间的一致性较差。我们的结果表明，临床医生应首先做出准确诊断，然后按照政府制定的临床诊断分类标准向网络报告。
