乙肝两对半的解读

乙肝两对半的解读Secondliverhalf-and-halhinterpretatino•乙肝两对半的定义TheDefinitinoOfSecongLiverTwoHalf-and-Half•大三阳和小三阳Big3thisworldandsmall3thisworld•乙肝的传播途径Thetransmissionwayofsecondliver*对乙肝的误解Misunderstandingofhepatitisb什么是乙肝两对半•乙肝两对半是国内医院最常用的乙肝病毒(HBV)感染检测血清标志物。(Secondlivertwohalf-and-halfisthemostcommonlyusedindomestichospitalofhepatitisbvirus(HBV)infectiondetectionserummarker)•①乙肝表面抗原（HBsAg）•②乙肝表面抗体（抗-HBs）•③乙肝e抗原（HBeAg）•④乙肝e抗体（抗-HBe）•⑤乙肝核心抗体（抗-HBc）测定两种抗原和三种抗体，也就是俗称的“两对半”。Determinationoftwokindsofantigensandthreekindsofantibody,alsoknownasthetwohalf-and-half.大三阳和小三阳Big3thisworldandsmall3thisworld•“大三阳”是指“乙肝两对半”化验结果为表面抗原、e抗原和核心抗体检测均是阳性。一般说明病毒复制水平高、传染性强。•Big3thisworldreferstosecondlivertwohalf-and-halftestresultsforthesurfaceantigen,eantigenandcoreantibodytestsarepositive.Generaldescriptionswithhigh-levelviralreplicationandinfectivity.•“小三阳”是指“乙肝两对半”化验结果为表面抗原、E抗体和核心抗体检测均是阳性。一般说明病毒复制水平相对较低、传染弱。•Whatissmall3thisworldsmall3thisworldreferstosecondlivertwohalf-and-halftestresultsforthesurfaceantigen,Eantibodyandcoreantibodytestsarepositive.Generaldescriptionsviralreplicationlevelisrelativelylowandweak.可见大三阳和小三阳的区别主要在病毒复制活跃程度上，但并不表示“大三阳”一定比“小三阳”病情严重，临床研究证实，有些小三阳患者更容易转化为肝癌。在治疗上，如果是乙肝患者且HBVDNA含量高，大三阳和小三阳的区别不大，都要以抗病毒治疗为主，辅助抗炎保肝，抗纤维化治疗。Visiblebig3thisworldandsmall3thisworlddifferenceismainlyintheviralreplicationactivity,butitdoesn'tmeanthebig3thisworldthansmall3thisworldthediseaseissevere,clinicalstudieshaveconfirmedthatsomesmall3thisworldaremorelikelytobeconvertedintolivercancerpatients.Intreatment,ifishepatitisbpatientsandhbvdnacontenthigh,thedifferencebetweenbig3thisworldandsmall3thisworldisnotbig,togiveprioritytowithantiviraltherapy,anti-inflammatory,protectingliver,auxiliaryantifibrosistreatment.乙肝的传播途径Thetransmissionwayofsecondliver血液传播（Bloodtransmission)：如输入被感染的全血、血浆、血清或其它血制品，或其他血源性注射传播。Suchasinputofwholeblood,plasma,seruminfectedorotherbloodproducts,orotherblood-bornespreadofinjection性传播(Sexuallytransmission)：性滥交、同性恋和异性恋之间的亲密性行为是重要的乙肝病毒传播途径，这种传播亦包括家庭夫妻间的传播，夫妻之间的无防御措施的性行为传播率大概在14%左右，具体引人而异。因乙肝病人的唾液中可以查到乙肝病毒，在接吻时有可能会由于皮肤粘膜破损造成传染。因此在口腔有破损（如溃疡，咬伤，牙龈出血等）的情况下应避免与乙肝病毒携带者亲吻。•Casualsexandintimacybetweenhomosexualandheterosexualsexisanimportantrouteoftransmission,hepatitisbvirusspreadthisalsoincludesthespreadoffamilyhusbandandwife,betweenhusbandandwife,withoutdefensemeasuresthesexuallytransmittedrateatabout14%,aboutthespecificvaries.Becauseofhepatitisbpatientssalivacangethepatitisbvirus,duringakissmaybecausedbydamagedskinandmucosainfected.Thusinthemouthisbroken(suchasulcers,bite,bleedinggums,etc.)ofthecasesshouldbeavoidedandkissthepersonthatsecondlivervirusiscarried.•母婴传播(Mother-to-childtransmission)：母婴传播约占50％以上，其中宫内感染约占4.54%，其余为分娩时的感染；分娩时母亲的血液、阴道分泌物通过胎儿的破损皮肤、粘膜而传染；胎盘剥离时微量血液漏至胎循环中；产前或产程中胎儿吸入母亲的血液、羊水、阴道分泌物而感染；•Mother-to-childtransmission(PMTCT)accountedforabout50%oftheabove,theintrauterineinfectionaccountedforabout4.54%,therestforchildbirthinfections;Birthmother'sblood,vaginalsecretionsinfectionbythebreakageofthefetalskin,mucousmembrane;Theplacentastrippingwhentracebloodleakageintothefetalcirculation;Antenatalfetalinhalationinthemother'sblood,amnioticfluid,orthestages,vaginalsecretionsandinfection;为何乙肝歧视问题如此“根固”？Whysodeephepatitisbdiscrimination?1、乙肝患者人数过于庞大，造成人们对乙肝产生恐慌的消极心理。Secondliverpatientnumberistoolarge,resultinginpeople'snegativepsychologicalpaniconhepatitisb.2、社会对于乙肝传播知识的不正确宣传，对人们造成误导。Societytospreadknowledgeofhepatitisbisnotcorrectpropaganda,tomisleadpeople.3、乙肝宣教力度不够，使乙肝“妖魔化”。Hepatitisbeducationisnotstrongenough,makethehepatitisbdemonised4、乙肝患者产生自卑心理，不敢正视自己的疾病。Secondliverpatienthavelowself-esteem,darenotfaceuptohisillness.•乙肝不通过消化道和呼吸道传播，所以日常接触如握手、拥抱、一起工作、吃饭等一般不会被乙肝病毒传播。但若和乙肝患者共餐的朋友有口腔溃疡等，与乙肝患者有血液暴露的接触，是有可能会传播乙肝病毒的。•Hepatitisbisnotspreadthroughthedigestivetractandrespiratorytract,socontactsuchasshakehands,hug,dailywork,suchaseatinggenerallywillnotbespreadhepatitisbvirus.Butifthefriendandhepatitisbpatientstodinnerwithoralulcer,etc.,contactwiththepatientswithhepatitisbbloodexposure,islikelytotransmitthehepatitisbvirus.谢谢Thankyou