Release date: 2017-03-23 Regardless of whether it is a doctor or a patient, get a two-and-a-half test report of hepatitis B to see which items are positive. Generally, the reports of Dasanyang, Xiaosanyang, and surface antibody positive and yin are familiar. Other positive combinations are often less clear about the clinical significance of their representation. The author once had a serious discussion with colleagues in the laboratory, and after they were popularized for a lesson, I was deeply impressed by the fact that there are successive orders, and the profession has specialization! Here, the author summarizes the clinical significance of many modes of hepatitis B two-and-a-half positive combination, and hopes to help everyone (whether doctor or patient)! First look at the clinical significance of the five items of hepatitis B, as shown below: (This form is from Yulu Ganlin WeChat public number) What is the OD value, Cut off value, S/CO value? In some hospitals, two-and-a-half of the reports of hepatitis B will have OD values, Cut off values, and S/CO values. It will also make many doctors unable to find their minds. In fact, the above values ​​are several data read by the instrument during the five tests of hepatitis B. The OD value indicates the absorbance, the Cut off value indicates the critical value of the control sample; and the S/CO ratio is the value used to determine the negative result. For the two pairs of hepatitis B (HBsAg, HBsAb, HBeAg) OD value S / CO > 1, it is positive, the latter two (HBeAb, HBcAb) OD value S / CO > 1 is the opposite, said negative. First, the common positive combination mode 1. HBsAg(+), HBsAb(-), HBeAg(+), HBeAb(-), HBcAb(+) Commonly known as the big three yang, that is, one, three, five positive. In the new edition of the "Guidelines for the Prevention and Treatment of Hepatitis B in China", there should be two standardized medical names for "Da Sanyang", which are chronic HBV carriers and e antigen-positive chronic hepatitis B. Hepatitis B virus immunological indicators in patients with chronic hepatitis B or hepatitis B virus carriers, namely hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and hepatitis B core antibody (anti-HBC) are positive, and these three indicators are often positive. In vivo viral replication is more active, but whether it causes severe liver cell damage, but also depends on the liver function test and the patient's self-conscious symptoms! Simply put, “big three yang†does not mean the severity of the disease. Its clinical significance can be summarized as: acute phase, chronic phase, and strong contagious. 2. HBsAg(+), HBsAb(-), HBeAg(-), HBeAb(+), HBcAb(+) Commonly known as Xiao Sanyang, that is, one for four five positive. In the new edition of the "Guidelines for the Prevention and Treatment of Hepatitis B in China", there are two standardized medical names for "Small Sanyang": inactive HBsAg carriers and HBeAg-negative chronic hepatitis B. The above combination of hepatitis B surface antigen (HBsAg), hepatitis B e antibody (HBeAb), hepatitis B core antibody (anti-HBC) three positive. What is different from Dasanyang is hepatitis B e antigen (HBeAg) negative. "Small Sanyang" patients are divided into two situations, one is the virus-negative Xiao Sanyang, and the other is the virus-positive Xiao Sanyang. Some people often think that the big Sanyang is serious and the small Sanyang is fine. It is actually a misunderstanding, the virus. The harm of positive Xiao Sanyang is increasingly valued by medical professionals. Xiao Sanyang also reflects the status of hepatitis B immune markers in the body after infection with hepatitis B virus, and it does not mean that the condition is serious. Its clinical significance can be summarized as: recovery period, weak contagious, long-term continuous cancer. 3. HBsAg(+), HBsAb(-), HBeAg(+), HBeAb(-), HBcAb(-) Commonly known as the second yang. It is the hepatitis B surface antigen and hepatitis B e antigen positive in the five hepatitis B cases, compared with the hepatitis B big three positive, only the hepatitis B core antibody is less. Active virus replication, strong contagiousness, severe liver damage, and obvious symptoms are common features of the second yang. The second yang is an unstable state. If it is not treated in time, it may lead to a rapid deterioration of the condition, and patients must be vigilant. Therefore, after the big three yang changes to the second yang, if the transaminase is elevated and the HBV-DNA is positive, the hepatitis B big three yang becomes the big yang and it is not seen that the condition becomes lighter. Its clinical significance can be summarized as: early HBV infection or chronic carrier active period, highly contagious. 4. HBsAg(+), HBsAb(-), HBeAg(-), HBeAb(-), HBcAb(+) Commonly known as Xiao Eryang. The simple diagnosis of hepatitis B in two pairs of hepatitis B does not indicate that the patient is infected or not infected with hepatitis B virus. In "Chronic Hepatitis B", it is clearly stated that: liver function is normal, virus volume is negative, and hepatitis B is one-five positive, which is called occult hepatitis. Xiao Eryang is a certain contagious. Hepatitis B small yang can be cured, but for patients with hepatitis B small yang, the best treatment is to pay attention to health care: to maintain a cheerful mood, participate in enhancing autoantibodies; reasonable diet, no drinking, try to quit smoking, to Avoid recurrence and aggravation of hepatitis B; moderate consumption of liver protection drugs. It is generally believed that Xiao Eryang is the intermediate stage of Dasanyang and Xiaosanyang. With the development of the disease and the progress of treatment, Xiao Eryang may become a small Sanyang, and may become a big Sanyang. Therefore, if there is a small yang in the course of treatment, it is generally not possible to stop the drug at will, so as not to cause the rebound of the disease or promote the mutation of the virus, resulting in losses. If necessary, check liver function and indicators such as HBV-DNA to see if there is a need to change the treatment plan. If you have a big Sanyang turn to a small yang in the absence of treatment, you should also check it in time to avoid missed treatment. Generally speaking, the big three yang to the small two yang think that the hepatitis B virus is inhibited by human immunity or (and) antiviral drugs, the virus replication is reduced, the condition is reduced, and the infection is low. But strictly speaking, Dasanyang and Xiaoyinyang do not represent the severity of the disease. It is necessary to combine liver function, B-ultrasound, and HBV-DNA to determine the severity of the condition. There is basically no difference between hepatitis B small Sanyang and hepatitis B small two yang. Hepatitis B small yang is unstable, and most of the hepatitis B small yang will be converted to hepatitis B small three yang. If Xiao Sanyang is directly converted to Xiao Eryang, it indicates that the condition has improved, but this does not mean that the condition of hepatitis B patients is absolutely reduced. It is necessary to combine the hepatitis B virus DNA test to determine the condition. Hepatitis B Xiaoyang and Xiaosanyang are easy to cause hepatitis B. Viral mutations are prone to cirrhosis, so it is necessary to periodically detect HBV-DNA replication. If there is a small yang, and the HBV-DNA is negative, the liver function is normal, indicating that the virus replication is basically stopped and no treatment is needed. Usually pay attention to: 1, life routine, ensure adequate sleep, do not excessive fatigue, do not stay up late; 2, eat more foods and fruits rich in protein and vitamins; 3, continue to quit smoking, abstain from alcohol; 4, appropriate sports , control the body weight within the standard range, do not blindly tonic. Its clinical significance can be summarized as: acute or chronic phase, the infection is weak. 5. HBsAg(-), HBsAb(+), HBeAg(-), HBeAb(+), HBcAb(+) Commonly known as Hui Sanyang. The fifth, fourth, and fifth items of hepatitis B were positive, and the other two were negative, indicating that it was the recovery period of hepatitis B and had immunity. The clinical significance can be summarized as: recovery period after acute infection, past infection, immunity. 6. HBsAg(-), HBsAb(+), HBeAg(-), HBeAb(-), HBcAb(+) Commonly known as Hui Eryang, hepatitis B five items 2, 5 positive. He has been infected with hepatitis B virus, and the virus has been basically cleared and the body is recovering. However, some patients still have abnormal liver function and HBV-DNA positive. If there is any mutation in the virus, treatment should continue. Therefore, the vast majority of people who are “second and fifth yang†are healthy people who have already developed immunity. If they are not at ease, they can further check HBV-DNA quantification and other examination items have been made clear. The clinical significance can be summarized as: previous infection, still immunity, atypical recovery period. 7. HBsAg(-), HBsAb(-), HBeAg(-), HBeAb(-), HBcAb(+) That is, the fifth and second half of hepatitis B are positive, and its clinical significance is: (1) previous infection, but has not been able to detect HBsAb; (2) recovery period after past; (3) multiple acute window period. 8. HBsAg(-), HBsAb(-), HBeAg(-), HBeAb(+), HBcAb(+) Hepatitis B is positive for both the fourth and fifth items. In the past, the recovery period of acute hepatitis B was basically non-infectious (a few were still contagious). 9. HBsAg(+), HBsAb(-), HBeAg(-), HBeAb(-), HBcAb(-) Hepatitis B is positive for two and a half items. In the late incubation period of acute viral infection (ie, early infection), chronic carriers are less contagious. 10. HBsAg(+), HBsAb(-), HBeAg(-), HBeAb(+), HBcAb(-) Hepatitis B is positive for both the first and fourth items. Carriers of chronic hepatitis B surface antigen are prone to vaginal discharge, or acute infection tends to recover, and infection is weak. 11. HBsAg(+), HBsAb(-), HBeAg(+), HBeAb(-), HBcAb(-) Hepatitis B is positive for both the first and third items. Hepatitis B infection is early or chronic carrier active, and is highly contagious. 12. HBsAg(+), HBsAb(-), HBeAg(+), HBeAb(+), HBcAb(+) Hepatitis B is positive for the first, third, fourth, and fifth items. Acute hepatitis B infection tends to recover, or is a chronic hepatitis B virus carrier. 13. HBsAg(+), HBsAb(+), HBeAg(-), HBeAb(-), HBcAb(-) Hepatitis B is positive for both the first and second items. In the early stage of subclinical infection of hepatitis B virus, secondary infection of different subtypes of HBV. 14. HBsAg(+), HBsAb(+), HBeAg(-), HBeAb(-), HBcAb(+) Hepatitis B is positive for the first, second and fifth items. In the early stage of subclinical infection of hepatitis B virus, secondary infection of different subtypes of HBV. 15. HBsAg(+), HBsAb(+), HBeAg(-), HBeAb(+), HBcAb(-) Hepatitis B is positive for the first, second, and fourth items. Hepatitis B virus subclinical infection or atypical hepatitis. 16. HBsAg(+), HBsAb(+), HBeAg(+), HBeAb(-), HBcAb(+) Hepatitis B is positive for the first, second, third, and fifth items. Hepatitis B virus subclinical infection or atypical hepatitis. 17. HBsAg(-), HBsAb(-), HBeAg(+), HBeAb(-), HBcAb(-) Hepatitis B is positive for the third and second half. Hepatitis B virus is atypical acute infection. 18. HBsAg(-), HBsAb(-), HBeAg(+), HBeAb(-), HBcAb(+) Hepatitis B is positive for the third and fifth items. Hepatitis B virus is atypical acute infection. 19. HBsAg(-), HBsAb(-), HBeAg(+), HBeAb(+), HBcAb(+) Hepatitis B is positive for the third, fourth and fifth items. Acute hepatitis B virus infection in the middle. 20. HBsAg(-), HBsAb(+), HBeAg(-), HBeAb(+), HBcAb(-) Hepatitis B is positive for the second and fourth items. Hepatitis B virus infection has recovered. 21. HBsAg(-), HBsAb(+), HBeAg(+), HBeAb(-), HBcAb(-) Hepatitis B is positive for the second and third items. Hepatitis B virus subclinical infection or atypical hepatitis. 22. HBsAg(-), HBsAb(+), HBeAg(+), HBeAb(-), HBcAb(+) Hepatitis B is positive for the second, third and fifth items. Hepatitis B virus subclinical infection or atypical hepatitis. 23. HBsAg(-), HBsAb(-), HBeAg(-), HBeAb(+), HBcAb(-) Hepatitis B is positive for the second and second half. Hepatitis B virus infection tends to recover and is generally non-infectious. Second, the normal combination mode 1. HBsAg(-), HBsAb(-), HBeAg(-), HBeAb(-), HBcAb(-) Five tests for hepatitis B were all negative. Not infected with hepatitis B virus. 2. HBsAg(-), HBsAb(+), HBeAg(-), HBeAb(-), HBcAb(-) Hepatitis B five items are positive. After the hepatitis B vaccine is injected, the hepatitis B virus has recovered after infection and is immune. Source: Laboratory Medicine (Micro Signal Labweb) Seeds,Palay Seeds,Hybrid Palay Seeds,Palay Seeds Variety XIKE AGRICULTURAL GROUP CO . .LTD. , https://www.laoseed.com