医学专题—乙肝两对半的解读34091.ppt

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1、乙肝两对半的解读(ji d)Second liver half-and-halh interpretatino第一页，共十四页。乙肝两对半的定义The Definitino Of Secong Liver Two Half-and-Half大三阳和小三阳Big3 this world and small 3this world乙肝的传播途径(tjng)The transmission way of second liver*对乙肝的误解Misunderstanding of hepatitis b 第二页，共十四页。什么(shn me)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)

2、感染检测血清(xuqng)标志物。(Second liver two half-and-half is the most commonly used in domestic hospital of hepatitis b virus(HBV)infection detection serum marker)乙肝表面抗原（HBsAg）乙肝表面抗体（抗-HBs）乙肝e抗原（HBeAg）乙肝e抗体（抗-HBe）乙肝核心抗体（抗-HBc）测定测定(cdng)两种抗原和三种抗体，也就是俗称的两种抗原和三种抗体，也就是俗称的“两对半两对半”。Determination of two kinds of an

3、tigens and three kinds of antibody,also known as the two half-and-half.第三页，共十四页。大三阳和小三阳 Big3 this world and small 3this world“大三阳大三阳”是指是指“乙肝两对半乙肝两对半”化验结果为表面抗原、化验结果为表面抗原、e抗原抗原(kngyun)和核心抗体检测均是阳性。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。一般说明病毒复制水平高、传染性强。Big 3 this world refers to second liver two half-and-half te

4、st results for the surface antigen,e antigen and core antibody tests are positive.General descriptions with high-level viral replication and infectivity.“小三阳小三阳”是指是指“乙肝两对半乙肝两对半”化验结果为表面抗原、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。平相对较低、传染弱。What is small 3 this world small 3 t

5、his world refers to second liver two half-and-half test results for the surface antigen,E antibody and core antibody tests are positive.General descriptions viral replication level is relatively low and weak.可见大三阳和小三阳的区别主要在病毒可见大三阳和小三阳的区别主要在病毒(bngd)复制活跃程度上，但并不表示复制活跃程度上，但并不表示“大三阳大三阳”一定比一定比“小三阳小三阳”病情严重

6、，临床研究证实，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。疗为主，辅助抗炎保肝，抗纤维化治疗。Visible big 3 this world and small 3 this world difference is mainly in the viral replication activity,but it doesnt mean the big 3

7、this world than small 3 this world the disease is severe,clinical studies have confirmed that some small 3 this world are more likely to be converted into liver cancer patients.In treatment,if is hepatitis b patients and hbvdna content high,the difference between big 3 this world and small 3 this wo

8、rld is not big,to give priority to with antiviral therapy,anti-inflammatory,protecting liver,auxiliary anti fibrosis treatment.第四页，共十四页。第五页，共十四页。第六页，共十四页。第七页，共十四页。乙肝的传播乙肝的传播(chunb)途径途径 The transmission way of second liver 血液传播（Blood transmission)：如输入被感染的全血、血浆、血清如输入被感染的全血、血浆、血清 或其它或其它血制品，或其他血源性注射传播血制

9、品，或其他血源性注射传播。Such as input of whole blood,plasma,serum infected or other blood products,or other blood-borne spread of injection 性传播(Sexually transmission)：性滥交、同性恋和异性恋之间的亲密性行性滥交、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无防御措施的性行为传播率大概在14%14%左右

10、，具体引人左右，具体引人(yn rn)(yn rn)而异。因乙肝而异。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。应避免与乙肝病毒携带者亲吻。Casual sex and intimacy between homosexual and heterosexual sex is an important route of transmission,hepatiti

11、s b virus spread this also includes the spread of family husband and wife,between husband and wife,without defense measures the sexually transmitted rate at about 14%,about the specific varies.Because of hepatitis b patients saliva can get hepatitis b virus,during a kiss may be caused by damaged ski

12、n and mucosa infected.Thus in the mouth is broken(such as ulcers,bite,bleeding gums,etc.)of the cases should be avoided and kiss the person that second liver virus is carried.第八页，共十四页。母婴传播(Mother-to-child transmission)：母婴传播约占母婴传播约占5050以上，其中宫内以上，其中宫内感染约占感染约占4.54%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，其余为分娩

13、时的感染；分娩时母亲的血液、阴道分泌物通过胎儿胎儿 的破损皮肤、粘膜而传染；胎盘剥离的破损皮肤、粘膜而传染；胎盘剥离(bl)(bl)时微量血液漏至胎循环中；产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、前或产程中胎儿吸入母亲的血液、羊水、阴道分泌物而感染；阴道分泌物而感染；Mother-to-child transmission(PMTCT)accounted for about 50%of the above,Mother-to-child transmission(PMTCT)accounted for about 50%of the above,the intraute

14、rine infection accounted for about 4.54%,the rest for the intrauterine infection accounted for about 4.54%,the rest for childbirth infections;Birth mothers blood,vaginal secretions infection by childbirth infections;Birth mothers blood,vaginal secretions infection by the breakage of the fetal skin,m

15、ucous membrane;The placenta stripping when the breakage of the fetal skin,mucous membrane;The placenta stripping when trace blood leakage into the fetal circulation;Antenatal fetal inhalation trace blood leakage into the fetal circulation;Antenatal fetal inhalation in the mothers blood,amniotic flui

16、d,or the stages,vaginal secretions and in the mothers blood,amniotic fluid,or the stages,vaginal secretions and infection;infection;第九页，共十四页。第十页，共十四页。为何乙肝歧视为何乙肝歧视(qsh)问题如此问题如此“根固根固”？Why so deep hepatitis b discrimination?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。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。Second liver patient

17、number is too large,resulting in peoples negative psychological Second liver patient number is too large,resulting in peoples negative psychological panic on hepatitis b.panic on hepatitis b.2、社会对于乙肝传播知识的不正确宣传，对人们造成误导社会对于乙肝传播知识的不正确宣传，对人们造成误导(w(w do)do)。Society to spread knowledge of hepatitis b is n

18、ot correct propaganda,to mislead Society to spread knowledge of hepatitis b is not correct propaganda,to mislead people.people.3、乙肝宣教力度不够，使乙肝乙肝宣教力度不够，使乙肝“妖魔化妖魔化”。Hepatitis b education is not strong enough,make the hepatitis b demonised Hepatitis b education is not strong enough,make the hepatitis b

19、demonised 4、乙肝患者产生自卑心理，不敢正视自己的疾病。乙肝患者产生自卑心理，不敢正视自己的疾病。Second liver patient have low self-esteem,dare not face up to his illness.Second liver patient have low self-esteem,dare not face up to his illness.第十一页，共十四页。乙肝不通过消化道和呼吸道传播，所以日常乙肝不通过消化道和呼吸道传播，所以日常(rchng)接触如握手、拥抱、一起工作、吃饭接触如握手、拥抱、一起工作、吃饭等一般不会被乙肝病毒传

20、播。但若和乙肝患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血液暴露的接触，是有可能会传播乙肝病毒的。的。Hepatitis b is not spread through the digestive tract and respiratory tract,so contact such as shake hands,hug,daily work,such as eating generally will not be spread hepatitis b virus.But if the friend and hepatitis b patients to dinner with oral ulcer,etc.,contact with the patients with hepatitis b blood exposure,is likely to transmit the hepatitis b virus.第十二页，共十四页。谢谢 谢谢Thank you第十三页，共十四页。内容(nirng)总结乙肝两对半的解读(ji d)第十四页，共十四页。