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本文报告1988年上海市甲型肝炎暴发流行期间1075例的自然病程和转归。89.3%患者于4个月内恢复正常,少数患者(1.4%)在病程的6个月内有1~2次的 ALT 波动,最终所有患者均于1年恢复正常工作。经5年的追踪观察无一例转为慢性肝炎。分析影响预后的各种因素,如年龄、性别、住院或留家、用药的方式和费用,均无明显差别。本文的研究再次表明甲型病毒性肝炎是一种良性、自愈性的疾病,不需特殊治疗。过多的治疗不仅无效,而且是一种浪费。
This article reports the natural history and outcome of 1075 patients during the 1988 Hepatitis A outbreak in Shanghai. 89.3% of the patients returned to normal within 4 months. In a small number of patients (1.4%), they experienced 1-2 cycles of ALT fluctuation within 6 months of course of disease. All patients eventually returned to normal after 1 year. After 5 years of follow-up observation, no case was converted to chronic hepatitis. There are no significant differences in the factors that influence the prognosis, such as age, sex, hospitalization or stay-home, and the manner and cost of medication. This study again shows that hepatitis A virus is a benign, self-healing disease, without special treatment. Too much treatment is not only ineffective, but also a waste.