Limb weakness, mental concentration, easy fatigue, difficulty lassitude, loss of appetite, nausea and vomiting, and with fever, listlessness, abdominal pain and indigestion. In addition to the increase of bilirubin in patients with hepatitis B, there will be jaundice symptoms, the symptoms of yellow skin, yellow eyes and yellow urine. There is often no symptoms, and the condition is not found.
1. Acute hepatitis B
It may be characterized by acute jaundice hepatitis and acute non jaundice hepatitis. Acute jaundice type may have typical clinical manifestations, such as fever, fatigue, anorexia, nausea, vomiting, abdominal distension, tired of the oil, liver pain, yellow urine Rucha water and so on, some patients even had the stool pale, skin itching, liver area tenderness and percussion pain, acute non icteric more occult, mild symptoms, like a mild fatigue, anorexia, nausea and discomfort, rapid recovery, often medical laboratory was found. Acute hepatitis B symptoms, the patient must pay attention to check and timely treatment, avoid illness chronicity development.
2. Chronic hepatitis B
According to the condition of the disease, it can be divided into three kinds of light, medium and heavy.
Mild, mild, repeated fatigue, dizziness, appetite decrease, tired of the oil, yellow urine, liver discomfort, poor sleep, liver slightly light tenderness, may have mild splenomegaly. Symptoms and signs were absent in some cases. Only 1 or 2 mild abnormalities of liver function were found.
Moderate: symptoms, signs, laboratory tests are between mild and severe.
3. Severe hepatitis
Extreme weakness, severe gastrointestinal symptoms, neurologic, mental symptoms (lethargy, character change, restlessness, coma, etc.)
4. Cholestatic hepatitis
Jaundice continues to not retreat for more than 3 weeks, known as cholestatic hepatitis. A special clinical type mainly characterized by intrahepatic cholestasis is also known as capillary cholangitis type hepatitis. Chronic cholestatic hepatitis often occurs on the basis of liver cirrhosis, which is not easy to fade, often accompanied by γ - glutamyl transpeptidase, alkaline phosphatase, and total bile acid.
5. Hepatitis cirrhosis
(1) according to the liver inflammation, it is divided into active and static type two.
Active cirrhosis: symptoms of chronic hepatitis, fatigue and digestive tract symptoms, increased ALT, jaundice, and albumin decline.
Static liver cirrhosis: no liver inflammatory activity, mild symptoms or no specificity, can have the above signs.
(2) according to the pathological and clinical manifestations of liver tissue, it is divided into compensatory cirrhosis and decompensated cirrhosis.
Compensatory cirrhosis: ALB = 35g/L, TBil < 35μ mol/L, PTA > 60%. There is a portal hypertension, but there is no ascites, hepatic encephalopathy or upper gastrointestinal bleeding.
Decompensated cirrhosis: middle and late stage cirrhosis, with obvious liver dysfunction and decompensation signs, such as ALB < 35g/L, albumin / globulin (A/G) < 1, TBil > 35μ mol/L, PTA < 60%. There can be obvious varicose or ruptured bleeding of the esophagus and the fundus of the stomach caused by ascites, hepatic encephalopathy or portal hypertension.
Three. Diagnostic criteria
There are three methods for the diagnosis of hepatitis B: the antigen test of the virus, the antibody test of the human body and the deoxyribonucleic acid test of the virus.
Antigen: the antigen of hepatitis B tested is two: hepatitis B surface antigen (HBs-Ag) and hepatitis B virus e antigen (HBe-Ag). If these two antigens exist, it is indicated that the patient is still sick. In the best case, the patient has only HBs-Ag and no symptoms, which indicates that the patient is healthy, but with the virus. If the patient has HBe-Ag in the body, his infection is very high, but even if only HBs-Ag patients can still be infected with others.
Antibodies: the antibodies to be tested for hepatitis B have two: Anti-HBc-IgM and Anti-HBcIgG, which are signs of recovery, and they will appear after vaccination. Anti-HBc-IgM is a sign of acute hepatitis B, and Anti-HBcIgG occurs at the end of acute hepatitis B or when the patient has just recovered. To test these antibodies that have improved conditions in patients with chronic hepatitis B, and appeal to drop.
Deoxyribonucleic acid: the old technology is used to test the DNA of hepatitis B virus. It mainly determines the condition of the disease in uncertain condition, and determines the infectivity of the patient. In modern medicine, this data is also used to diagnose and observe chronic hepatitis B. The number of virus deoxyribonucleic acid in the blood indicates that the disease is not aggravated, and the number of the disease is much more indicating the deterioration of the disease.
1. auxiliary examination
Liver function examination
It includes bilirubin, thymol turbidity test, AST, ALT, A/G, prothrombin time, serum protein electrophoresis, etc.
2. specific serological examination
It includes HBsAg, anti -HBs, HBeAg, anti -HBe, anti -HBc, and anti -HBcIgM. Conditions can be detected for HBV-DNA, DNA-p, Pre-S1, Pre-S2 and so on. In situ hybridization was used to detect HBV-DNA in the liver.
1. acute hepatitis B
Before the symptoms appear, the virus may have been latent for a few months. During this period, the contagion is very high, and the patient may unconsciously pass on to the person who is in contact with him. The early symptoms caused by hepatitis B are not very obvious, just like a bad cold, including mild fever, exhaustion, muscle pain, headache, loss of appetite, and aversion to smoking. Afterwards, nausea and vomiting, upper abdominal discomfort and sore pain, constipation or diarrhea will happen. As the course becomes worse, the skin will turn yellow and white, the color of urine