Pathological causes of viral hepatitis

The basic introduction of viral hepatitis

Viral hepatitis is caused by a variety of hepatitis virus common infectious diseases, with strong infectious, complex transmission pathways, a wide epidemic area, the incidence rate is higher and so on. Clinically, the main manifestations of fatigue, loss of appetite, nausea, vomiting, hepatomegaly and liver damage, some patients may have jaundice and fever. Some patients with urticaria, joint pain or upper respiratory symptoms, viral hepatitis sub-type A, B, C, D and hepatitis E five.

Viral hepatitis symptoms and signs

Viral hepatitis  is caused by hepatitis disease, the main symptoms of fatigue, loss of appetite, abnormal liver function, some patients may have fever and jaundice, and some persistent or recurrent episodes of chronic; a few people develop into severe hepatitis , Severe hepatitis disease dangerous, high mortality, the main cause of death is hepatic coma, liver failure, electrolyte imbalance and secondary infection, viral hepatitis  can be divided into A, B, C, D, E five types, No cross-immunity between the same time or successively infected, mixed infection or overlapping infection, the symptoms increased, hepatitis A and hepatitis  E to fecal one-based transmission, common fever, jaundice, was acute, Chronic persistent into chronic; hepatitis B and hepatitis C virus, and more by blood transfusion or blood products and close contact with the spread of easy to develop into chronic, or even cirrhosis, hepatitis  B virus infection has been confirmed and liver cancer have a certain relationship , Hepatitis D virus hepatitis D hepatitis B virus depends on the existence and replication, often mixed with hepatitis  B virus infection or hepatitis B virus-positive chronic hepatitis B in the course of overlap infection.

Pathological causes of viral hepatitis 

hepatitis  C virus (HCV) can be spread by blood, in 1989 the United States Choo, etc. from infected chimpanzee blood samples, in 1 million clones, only to find a positive clone, then named for the hepatitis C virus, HCV is a A shell, size of 30~80nm single-stranded RNA virus, replication in the liver cells, the 1: 1000 formalin 37℃ hours of treatment, heating 100℃ minutes or 60℃ hours, the infectivity disappeared, So far, hepatitis  C virus gene structure has been clear, according to the isolation of a large number of HCV strains to determine all of its molecules to 9416 base pairs, nucleocapsid and envelope proteins from the genome of the 5 ‘end coding, HCV core conservative, shell coding region More susceptible to mutation, foreign scholars based on the hepatitis  C virus gene sequence of the nucleotide sequence analysis, Weiner, etc. from hepatitis C patients were isolated from six genomes of HCV, of which at least four of the world recognized the main genotype , HCJ Ⅰ, Ⅱ HCJ, BK, HcJ4, is the main type of Japan, HCJ6 for type III, HCJ7 for type Ⅳ, most of the hepatitis  C patient serum HCV gene Type Ⅱ, for example, 33 cases of chronic hepatitis C serum hepatitis C virus RNA genotyping in Shanghai, of which type Ⅱ accounted for 22 cases (66.6%), the HCV gene sequence analysis for the preparation of early diagnosis of HCV reagents provide a theoretical basis, E1 and E2/NS1 region, which are important antigenic sites on the outer membrane protein of virus. The variability of this region has reference significance in diagnosis screening, immunoprophylaxis, persistent infection of HCV and so on.

Hepatitis  C virus in vitro culture has been successful, the normal chimpanzee inoculation of HCV 15 days after its serum can be detected in HCV-RNA, sustained positive time of about 3 weeks, 2 days after inoculation of HCV, the liver can also be detected hepatitis C virus RNA, anti-HCV 3 to 8 months after inoculation was positive.

Treatment of viral hepatitis 

Generally take comprehensive therapy, the vast majority of patients with hepatitis can be restored to health, the principle of appropriate treatment to rest, reasonable nutrition, appropriate supplemented by drugs, avoid alcohol, excessive fatigue and the use of drugs harmful to the liver, various types of hepatitis treatment as follows.

(A), acute hepatitis  The disease is a self-limiting disease, if the early diagnosis, to take appropriate rest, nutrition and general supportive therapy, the majority of patients in 3 to 6 months to heal, the clinical symptoms of Benedict or Jaundice and severe acute hepatitis patients should be given intravenous hypertonic glucose solution, vitamin C, liver Taile, aspartate potassium magnesium and other drugs or added with heat and dampness (Artemisia Decoction) of traditional Chinese medicine treatment of acute jaundice Hepatitis B should not be treated with adrenal cortical hormone, a group of 1805 cases of acute hepatitis patients in 911 cases of hormone therapy, more than 894 cases only vitamin and other general drug treatment as a control, after 18 to 24 months Follow-up and found that patients with hormone therapy group and repeated the evolution of chronic hepatitis were more than the control group, hepatitis A patients rarely evolved into chronic, so if the depth of jaundice (intrahepatic cholestasis deposition), by other therapy is invalid, Can still be considered with hormone therapy in our hospital in 1989, 648 cases of hepatitis A, 12 patients with deep jaundice, of which 7 cases of hormone therapy, the effect is obvious, the hormone to choose succinate hydrocortisone or prednisolone Is appropriate, the former dose of 200~300mg plus 10% glucose solution 500ml intravenous infusion, every 7 to 10 days according to the improvement of liver function can be gradually reduced, the latter dose of 30~40mg/d, then gradually reduce The amount of 5~10mg/d for the maintenance dose, the total course of 2 to 3 months; these patients, after 1 year follow-up were recovered, no disease course repeatedly.

(B), chronic hepatitis , chronic viral hepatitis is still lack of effective treatment, in view of the pathogenesis of this disease may be related to the virulence of the virus, the number of infected liver cells and the immune system and other factors have a certain relationship, it Application of antiviral drugs, to adjust the immune function and improve liver function of drug therapy, may play a role.

Preventive care of viral hepatitis

Prevention of viral hepatitis should be taken to cut off the transmission path as the focus of comprehensive preventive measures, such as focusing on water conservation, drinking water disinfection, food hygiene, manure management of hepatitis A cut off the spread of great significance.

For hepatitis B and C, the focus is to prevent the spread of blood and body fluids, a variety of medical and preventive injections (including skin tests, BCG vaccination, etc.) should be implemented one needle a tube, with serum contaminants should be strictly disinfected Treatment, dialysis wards should strengthen health management, blood products should be strictly tested, such as HBV-positive, shall not be sold and used.