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探讨重型病毒性肝炎的病原学特点。收集各型重型病毒性肝炎４１８例，分析其病原学分型及乙型肝炎病毒不同病原学模式与重型肝炎预后的关系。急性重型肝炎以甲型、戊型及乙型病毒性肝炎为主，乙型肝炎病毒感染治愈后病毒阴转率较高。亚急性及慢性重型肝炎以乙型肝炎病毒感染居首，占９２．８％。在乙型肝炎病毒感染的病原学模式中，以 ＨＢｓＡｇ ＨＢｅＡｂ ＨＢｃＡｂ阳性的重型肝炎发病及死亡率最高。乙型肝炎病毒与其他肝炎病毒重叠感染与单独感染比较，死亡率无显著差异。单纯ＴＴＶ感染可导致重型肝炎。重型肝炎发病后ＨＢＶＤＮＡ可自然阴转，阴转率可达５３．６％。重型肝炎仍以乙型肝炎病毒感染为主。乙型肝炎病毒前Ｃ区发生基因突变可能较易发生重型肝炎。
To explore the etiological characteristics of severe viral hepatitis. A total of 418 cases of various types of severe viral hepatitis were collected to analyze the relationship between their pathogenic classification and the different etiological patterns of hepatitis B virus and the prognosis of severe hepatitis. Acute severe hepatitis A, E and hepatitis B virus-based, hepatitis C virus infection cured after the virus negative rate higher. Subacute and chronic severe hepatitis with hepatitis B virus infection, accounting for 92.8%. In the etiological pattern of hepatitis B virus infection, HBsAg HBeAb HBcAb-positive severe hepatitis has the highest morbidity and mortality. Hepatitis B virus and other hepatitis viruses overlap infection compared with infection alone, no significant difference in mortality. TTV infection can lead to severe hepatitis. After the onset of severe hepatitis, HBVDNA may naturally turn negative, negative conversion rate of up to 53.6%. Hepatitis B virus infection is still predominant in severe hepatitis. Hepatitis C virus pre-C gene mutation may be more prone to severe hepatitis.