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,alsoknownasthe"twohalf-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。•"Big3thisworld"refersto"secondlivertwohalf-and-half"testresultsforthesurfaceantigen,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。•Whatissmall3thisworld"small3thisworld"refersto"secondlivertwohalf-and-half"testresultsforthesurfaceantigen,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'tmeanthe"big3thisworld"than"small3thisworld"thediseaseissevere,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...
