Gimson A E, White Y S, Eddleston A L, Williams R
Gut. 1983 Dec;24(12):1194-8. doi: 10.1136/gut.24.12.1194.
In 73 patients with fulminant viral hepatitis, non-A non-B hepatitis (NANB) was most common (43.8%), with hepatitis type A (HAV) diagnosed in 31.5% and hepatitis type B (HBV) in 24.7%. The non-A non-B group had a significantly longer duration from the onset of symptoms to the appearance of encephalopathy (median 21 days) compared with the HAV and HBV groups (medians 10 and seven days, p less than 0.01 and p less than 0.005 respectively). In the HAV group the severity of liver damage, judged by the maximum prolongation of the prothrombin time, was significantly less than in the HBV group (58 and 150 seconds prolonged respectively, p less than 0.005), and cerebral oedema was significantly less frequent (39% and 72% respectively, p less than 0.05). Consistent with this, the survival rate was higher in the HAV group (43.4%) compared with the HBV group (16.6%) and NANB group (9.3%) (p less than 0.005). These variations in presentation and clinical course may be a consequence of differences in the pathogenesis of the hepatic necrosis.
在73例暴发性病毒性肝炎患者中，非甲非乙型肝炎（NANB）最为常见（43.8%），甲型肝炎（HAV）占31.5%，乙型肝炎（HBV）占24.7%。与甲型肝炎和乙型肝炎组相比，非甲非乙组从症状出现到出现脑病的持续时间明显更长（中位数为21天），甲型肝炎和乙型肝炎组的中位数分别为10天和7天（p分别小于0.01和p小于0.005）。在甲型肝炎组中，以凝血酶原时间的最大延长来判断，肝损伤的严重程度明显低于乙型肝炎组（分别延长58秒和150秒，p小于0.005），脑水肿的发生率也明显较低（分别为39%和72%，p小于0.05）。与此一致的是，甲型肝炎组的生存率（43.4%）高于乙型肝炎组（16.6%）和非甲非乙组（9.3%）（p小于0.005）。这些临床表现和临床病程的差异可能是肝坏死发病机制不同的结果。
