text stringlengths 4 4.87k | entities list |
|---|---|
克-雅病@可伴有视觉障碍、感觉障碍以及构音障碍等。 | [
{
"id": 0,
"entity": "克-雅病",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "视觉障碍",
"start_offset": 8,
"end_offset": 12,
"label": "sym"
},
{
"id": 2,
"entity": "感觉障碍",
"start_offset": 13,
"end_offset": 17,
"label": "sym"... |
克-雅病@最终发展至植物状态并很快死亡。 | [
{
"id": 0,
"entity": "克-雅病",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "最终发展至植物状态并很快死亡",
"start_offset": 5,
"end_offset": 19,
"label": "sym"
}
] |
克-雅病@通常病程为1～15个月，平均6～7个月。 | [
{
"id": 0,
"entity": "克-雅病",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
}
] |
克-雅病@CJD的脑电图均有异常发现。 | [
{
"id": 0,
"entity": "克-雅病",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "CJD的脑电图",
"start_offset": 5,
"end_offset": 12,
"label": "pro"
}
] |
克-雅病@随病程进展呈进行性慢化，某些病例呈周期性异常，表现为高波幅慢波和尖波暴发，继以相对低平活动。 | [
{
"id": 0,
"entity": "克-雅病",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "高波幅慢波和尖波暴发",
"start_offset": 31,
"end_offset": 41,
"label": "sym"
},
{
"id": 2,
"entity": "继以相对低平活动",
"start_offset": 42,
"end_offset": 50,
"la... |
克-雅病@脑脊液可仅有轻度蛋白升高。 | [
{
"id": 0,
"entity": "克-雅病",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "脑脊液可仅有轻度蛋白升高",
"start_offset": 5,
"end_offset": 17,
"label": "sym"
}
] |
克-雅病@本病诊断也有赖于病理检查，病理改变的特点是：大脑皮层各层均有神经细胞脱失，伴明显星形细胞增生，肉眼一般均可见大脑皮层萎缩。 | [
{
"id": 0,
"entity": "克-雅病",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "脑皮层各层均有神经细胞脱失",
"start_offset": 28,
"end_offset": 41,
"label": "sym"
},
{
"id": 2,
"entity": "伴明显星形细胞增生",
"start_offset": 42,
"end_offset": 51,
... |
克-雅病@海绵样变在皮质深层特别明显，镜下改变更为显著。 | [
{
"id": 0,
"entity": "克-雅病",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "海绵样变在皮质深层特别明显",
"start_offset": 5,
"end_offset": 18,
"label": "sym"
},
{
"id": 2,
"entity": "镜下改变更为显著",
"start_offset": 19,
"end_offset": 27,
"... |
克-雅病@小脑改变以颗粒细胞减少为主，伴各层致密纤维胶质增生。 | [
{
"id": 0,
"entity": "克-雅病",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "小脑改变以颗粒细胞减少为主",
"start_offset": 5,
"end_offset": 18,
"label": "sym"
},
{
"id": 2,
"entity": "伴各层致密纤维胶质增生",
"start_offset": 19,
"end_offset": 30,
... |
克-雅病@进展迅速的病例海绵样变更突出，死亡较晚的病例则出现更明显的胶质增生。 | [
{
"id": 0,
"entity": "克-雅病",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "进展迅速的病例海绵样变更突出",
"start_offset": 5,
"end_offset": 19,
"label": "sym"
},
{
"id": 2,
"entity": "死亡较晚的病例则出现更明显的胶质增生",
"start_offset": 20,
"end_offset"... |
克-雅病@对本病目前尚缺乏特效治疗，只能给予对症性处理。 | [
{
"id": 0,
"entity": "克-雅病",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
}
] |
克-雅病@（秦炯）。 | [
{
"id": 0,
"entity": "克-雅病",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
}
] |
二、乙型肝炎【病原和流行病学】乙型肝炎病毒（hepatitisBvirus，HBV）又称Dane颗粒，属嗜肝DNA病毒科，有双层结构，外层为脂蛋白包膜，含糖蛋白，即表面抗原（HBsAg）；内为核衣壳，含核心抗原（HBcAg）。 | [
{
"id": 0,
"entity": "乙型肝炎",
"start_offset": 2,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "乙型肝炎病毒",
"start_offset": 15,
"end_offset": 21,
"label": "mic"
},
{
"id": 2,
"entity": "hepatitisBvirus",
"start_offset": 22,
"end_offset": 37,
... |
后者被分泌入血或定位于感染细胞膜。 | [
{
"id": 0,
"entity": "血",
"start_offset": 6,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "感染细胞膜",
"start_offset": 11,
"end_offset": 16,
"label": "bod"
}
] |
根据HBsAg亚型抗原决定簇差异性，现已将HBV分为10个亚型，主要亚型为adw、adr、ayw和ayr。 | [
{
"id": 0,
"entity": "HBV",
"start_offset": 21,
"end_offset": 24,
"label": "mic"
},
{
"id": 1,
"entity": "adw",
"start_offset": 37,
"end_offset": 40,
"label": "mic"
},
{
"id": 2,
"entity": "adr",
"start_offset": 41,
"end_offset": 44,
"label": "mic"... |
我国长江以北adr占优势，长江以南adr和adw混存，少数民族地区以adw为主。 | [
{
"id": 0,
"entity": "adr",
"start_offset": 6,
"end_offset": 9,
"label": "mic"
},
{
"id": 1,
"entity": "adr",
"start_offset": 17,
"end_offset": 20,
"label": "mic"
},
{
"id": 2,
"entity": "adw",
"start_offset": 21,
"end_offset": 24,
"label": "mic"
... |
已发现多种HBV变异株，常见preC、C和S区基因变异。 | [
{
"id": 0,
"entity": "HBV",
"start_offset": 5,
"end_offset": 8,
"label": "mic"
}
] |
HBV对外界环境的抵抗力很强，能耐受干燥、60℃10小时、紫外线照射和一般消毒剂。 | [
{
"id": 0,
"entity": "HBV",
"start_offset": 0,
"end_offset": 3,
"label": "mic"
},
{
"id": 1,
"entity": "紫外线照射",
"start_offset": 29,
"end_offset": 34,
"label": "pro"
}
] |
煮沸10分钟、高压灭菌法、89-89乙肝消毒剂（2%、5秒钟，0.5%、3～5分钟）、2%过氧乙酸浸泡2分钟可灭活之。 | [
{
"id": 0,
"entity": "高压灭菌法",
"start_offset": 7,
"end_offset": 12,
"label": "pro"
},
{
"id": 1,
"entity": "89-89乙肝消毒剂",
"start_offset": 13,
"end_offset": 23,
"label": "dru"
},
{
"id": 2,
"entity": "过氧乙酸",
"start_offset": 45,
"end_offset": 49,
"labe... |
HBV尚不能体外分离培养。 | [
{
"id": 0,
"entity": "HBV",
"start_offset": 0,
"end_offset": 3,
"label": "mic"
}
] |
黑猩猩是HBV最理想的实验模型动物。 | [
{
"id": 0,
"entity": "HBV",
"start_offset": 4,
"end_offset": 7,
"label": "mic"
}
] |
乙型肝炎（viralhepatitisB，简称乙肝），呈全球性流行，我国为高流行区，人群总感染率为35.5%～61.6%。 | [
{
"id": 0,
"entity": "乙型肝炎",
"start_offset": 0,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "viralhepatitisB",
"start_offset": 5,
"end_offset": 20,
"label": "dis"
},
{
"id": 2,
"entity": "乙肝",
"start_offset": 23,
"end_offset": 25,
"labe... |
约1.2亿人为HBsAg携带者，高峰年龄段为10岁以下和30～40岁组，传染源主要是乙肝患者和HBV携带者，病毒存在肝及肝外组织和血液中，通过各种体液排至体外。 | [
{
"id": 0,
"entity": "乙肝",
"start_offset": 42,
"end_offset": 44,
"label": "dis"
},
{
"id": 1,
"entity": "HBV",
"start_offset": 47,
"end_offset": 50,
"label": "mic"
},
{
"id": 2,
"entity": "病毒",
"start_offset": 54,
"end_offset": 56,
"label": "mic"
... |
儿童HBV感染最主要的传播途径为母婴传播。 | [
{
"id": 0,
"entity": "儿童HBV感染",
"start_offset": 0,
"end_offset": 7,
"label": "dis"
}
] |
母婴传播率为40%～60%，如果母亲HBsAg和HBeAg双阳性，则高达90%，多发生于产时（经产道感染），宫内传播率为5%～15%，生后经密切接触和食入带病毒的母乳可获HBV感染。 | [
{
"id": 0,
"entity": "产道",
"start_offset": 48,
"end_offset": 50,
"label": "bod"
},
{
"id": 1,
"entity": "产道感染",
"start_offset": 48,
"end_offset": 52,
"label": "sym"
},
{
"id": 2,
"entity": "病毒",
"start_offset": 78,
"end_offset": 80,
"label": "mic"
... |
水平传播方式主要包括注射和输注血制品，医疗器材和操作如内镜、牙科或手术器械、血透或腹透等，以及生活密切接触传播如家庭内聚集现象和集体机构内流行。 | [
{
"id": 0,
"entity": "注射",
"start_offset": 10,
"end_offset": 12,
"label": "pro"
},
{
"id": 1,
"entity": "输注血制品",
"start_offset": 13,
"end_offset": 18,
"label": "pro"
},
{
"id": 2,
"entity": "内镜",
"start_offset": 27,
"end_offset": 29,
"label": "equ"... |
【发病机制和病理改变】HBV经皮肤或黏膜进入血液循环，肝脏是其主要靶器官，但在胰腺、胆管上皮、肾小球、血管上皮、骨髓、性腺、胎盘、脾和外周血单个核细胞内都能找到病毒。 | [
{
"id": 0,
"entity": "HBV",
"start_offset": 11,
"end_offset": 14,
"label": "mic"
},
{
"id": 1,
"entity": "皮肤",
"start_offset": 15,
"end_offset": 17,
"label": "bod"
},
{
"id": 2,
"entity": "黏膜",
"start_offset": 18,
"end_offset": 20,
"label": "bod"
... |
HBV并不直接损伤靶细胞。 | [
{
"id": 0,
"entity": "HBV",
"start_offset": 0,
"end_offset": 3,
"label": "mic"
},
{
"id": 1,
"entity": "靶细胞",
"start_offset": 9,
"end_offset": 12,
"label": "bod"
}
] |
目前认为，针对肝细胞表面病毒编码抗原的CTL是构成肝细胞损伤和最终清除病毒的机制。 | [
{
"id": 0,
"entity": "肝细胞",
"start_offset": 7,
"end_offset": 10,
"label": "bod"
},
{
"id": 1,
"entity": "病毒",
"start_offset": 12,
"end_offset": 14,
"label": "mic"
},
{
"id": 2,
"entity": "肝细胞",
"start_offset": 25,
"end_offset": 28,
"label": "bod"
... |
最近在转基因鼠中发现存在非溶细胞性T细胞灭活病毒作用（通过CTL分泌IFN-γ和TNF-α或其他淋巴因子所介导），可能是机体清除病毒的另一途径。 | [
{
"id": 0,
"entity": "病毒",
"start_offset": 22,
"end_offset": 24,
"label": "mic"
},
{
"id": 1,
"entity": "病毒",
"start_offset": 64,
"end_offset": 66,
"label": "mic"
}
] |
如果病毒抗原不被识别或机体免疫应答不足，则形成持续病毒携带或表现为慢性肝炎；只有当机体产生有效的CTL和中和性抗体，才能清除病毒。 | [
{
"id": 0,
"entity": "病毒抗原",
"start_offset": 2,
"end_offset": 6,
"label": "mic"
},
{
"id": 1,
"entity": "病毒",
"start_offset": 25,
"end_offset": 27,
"label": "mic"
},
{
"id": 2,
"entity": "慢性肝炎",
"start_offset": 33,
"end_offset": 37,
"label": "dis"
... |
围生期或幼龄期感染HBV易发生持续病毒携带或慢性肝炎，与机体对HBV产生免疫耐受有关。 | [
{
"id": 0,
"entity": "HBV",
"start_offset": 9,
"end_offset": 12,
"label": "mic"
},
{
"id": 1,
"entity": "持续病毒携带",
"start_offset": 15,
"end_offset": 21,
"label": "sym"
},
{
"id": 2,
"entity": "慢性肝炎",
"start_offset": 22,
"end_offset": 26,
"label": "d... |
我国学者提出，对HBV包膜抗原（主要是HBsAg）的免疫耐受是其主要耐受机制。 | [
{
"id": 0,
"entity": "HBV包膜抗原",
"start_offset": 8,
"end_offset": 15,
"label": "mic"
}
] |
HBV可致膜性肾小球肾炎等肝外损害，与HBV抗体形成的免疫复合物性损伤有关。 | [
{
"id": 0,
"entity": "HBV",
"start_offset": 0,
"end_offset": 3,
"label": "mic"
},
{
"id": 1,
"entity": "膜性肾小球肾炎",
"start_offset": 5,
"end_offset": 12,
"label": "dis"
},
{
"id": 2,
"entity": "肝",
"start_offset": 13,
"end_offset": 14,
"label": "bod"
... |
乙肝的病理变化主要表现为肝细胞变性（常见水肿性和嗜酸性变）、不同程度坏死（点状、灶状、桥状或碎屑状坏死）和再生。 | [
{
"id": 0,
"entity": "乙肝",
"start_offset": 0,
"end_offset": 2,
"label": "dis"
},
{
"id": 1,
"entity": "肝细胞",
"start_offset": 12,
"end_offset": 15,
"label": "bod"
},
{
"id": 2,
"entity": "肝细胞变性",
"start_offset": 12,
"end_offset": 17,
"label": "sym"
... |
汇管区和肝实质可见淋巴细胞、单核细胞、浆细胞和组织细胞浸润。 | [
{
"id": 0,
"entity": "汇管区",
"start_offset": 0,
"end_offset": 3,
"label": "bod"
},
{
"id": 1,
"entity": "肝实质",
"start_offset": 4,
"end_offset": 7,
"label": "bod"
},
{
"id": 2,
"entity": "淋巴细胞",
"start_offset": 9,
"end_offset": 13,
"label": "bod"
}... |
其他可见淤胆或胆栓形成、胆小管增生、纤维组织增生等。 | [
{
"id": 0,
"entity": "淤胆或胆栓形成",
"start_offset": 4,
"end_offset": 11,
"label": "sym"
},
{
"id": 1,
"entity": "胆小管",
"start_offset": 12,
"end_offset": 15,
"label": "bod"
},
{
"id": 2,
"entity": "胆小管增生",
"start_offset": 12,
"end_offset": 17,
"label": ... |
临床分为5型：急性肝炎、慢性肝炎、重型肝炎、淤胆型肝炎和肝炎肝硬化。 | [
{
"id": 0,
"entity": "急性肝炎",
"start_offset": 7,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "慢性肝炎",
"start_offset": 12,
"end_offset": 16,
"label": "dis"
},
{
"id": 2,
"entity": "重型肝炎",
"start_offset": 17,
"end_offset": 21,
"label": "di... |
幼龄或围生期感染易表现为慢性病毒携带状态。 | [
{
"id": 0,
"entity": "围生期感染",
"start_offset": 3,
"end_offset": 8,
"label": "sym"
},
{
"id": 1,
"entity": "病毒",
"start_offset": 14,
"end_offset": 16,
"label": "mic"
},
{
"id": 2,
"entity": "慢性病毒携带",
"start_offset": 12,
"end_offset": 18,
"label": "sy... |
（一）急性肝炎分为急性无黄疸型和急性黄疸型，临床表现与甲肝类似。 | [
{
"id": 0,
"entity": "急性肝炎",
"start_offset": 3,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "急性无黄疸型",
"start_offset": 9,
"end_offset": 15,
"label": "dis"
},
{
"id": 2,
"entity": "急性黄疸型",
"start_offset": 16,
"end_offset": 21,
"label": "d... |
（二）慢性肝炎急性肝炎病程超过半年或原有乙型肝炎HBsAg携带史，本次因HBV出现肝炎病情者。 | [
{
"id": 0,
"entity": "慢性肝炎",
"start_offset": 3,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "急性肝炎",
"start_offset": 7,
"end_offset": 11,
"label": "dis"
},
{
"id": 2,
"entity": "乙型肝炎",
"start_offset": 20,
"end_offset": 24,
"label": "dis"... |
1.轻度症状、体征轻微或缺如，肝功能指标仅1项或2项轻度异常，如ALT≤正常3倍、胆红素≤正常2倍、γ球蛋白≤21%、凝血酶原活动度（PTA）＞70%。 | [
{
"id": 0,
"entity": "肝功能指标仅1项或2项轻度异常",
"start_offset": 15,
"end_offset": 30,
"label": "sym"
},
{
"id": 1,
"entity": "ALT",
"start_offset": 32,
"end_offset": 35,
"label": "ite"
},
{
"id": 2,
"entity": "胆红素",
"start_offset": 41,
"end_offset": 44,
"l... |
肝活检炎症活动度（G）分级为1～2，纤维化程度（S）分期为0～2。 | [
{
"id": 0,
"entity": "肝活检炎症活动度",
"start_offset": 0,
"end_offset": 8,
"label": "ite"
},
{
"id": 1,
"entity": "纤维化程度",
"start_offset": 18,
"end_offset": 23,
"label": "ite"
}
] |
肝活检呈G3级、S1～3期。 | [
{
"id": 0,
"entity": "肝活检",
"start_offset": 0,
"end_offset": 3,
"label": "ite"
}
] |
3.重度有明显或持续肝炎症状如乏力、食欲缺乏、腹胀等，伴肝掌、蜘蛛痣、脾大但无门脉高压者，ALT反复或持续升高。 | [
{
"id": 0,
"entity": "肝炎",
"start_offset": 10,
"end_offset": 12,
"label": "dis"
},
{
"id": 1,
"entity": "乏力",
"start_offset": 15,
"end_offset": 17,
"label": "sym"
},
{
"id": 2,
"entity": "食欲缺乏",
"start_offset": 18,
"end_offset": 22,
"label": "sym"
... |
此外，清蛋白明显下降，TB＞正常5倍，PTA为60%～40%，胆碱酯酶＜2500U/L，这4项指标中至少有一项符合，肝活检为G4级，S2～4期改变。 | [
{
"id": 0,
"entity": "清蛋白明显下降",
"start_offset": 3,
"end_offset": 10,
"label": "sym"
},
{
"id": 1,
"entity": "TB",
"start_offset": 11,
"end_offset": 13,
"label": "ite"
},
{
"id": 2,
"entity": "PTA",
"start_offset": 19,
"end_offset": 22,
"label": "it... |
（三）重型肝炎分为急性、亚急性和慢性重型肝炎。 | [
{
"id": 0,
"entity": "重型肝炎",
"start_offset": 3,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "急性、亚急性和慢性重型肝炎",
"start_offset": 9,
"end_offset": 22,
"label": "dis"
}
] |
前两者临床表现同甲型重型肝炎。 | [
{
"id": 0,
"entity": "甲型重型肝炎",
"start_offset": 8,
"end_offset": 14,
"label": "dis"
}
] |
慢性重型肝炎是在慢性HBV携带或慢性肝炎或肝硬化基础上发生，起病时临床表现同亚急性重型肝炎，随病情发展而加重，有出血倾向（PTA＜40%），黄疸加深（TB＞正常10倍），腹水、肝性脑病等重症表现。 | [
{
"id": 0,
"entity": "慢性重型肝炎",
"start_offset": 0,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "慢性HBV携带",
"start_offset": 8,
"end_offset": 15,
"label": "dis"
},
{
"id": 2,
"entity": "慢性肝炎",
"start_offset": 16,
"end_offset": 20,
"label": ... |
肝活检可见慢性肝病病变背景上出现大块性或亚大块性新鲜肝实质坏死。 | [
{
"id": 0,
"entity": "肝活检",
"start_offset": 0,
"end_offset": 3,
"label": "pro"
},
{
"id": 1,
"entity": "慢性肝病",
"start_offset": 5,
"end_offset": 9,
"label": "dis"
},
{
"id": 2,
"entity": "肝实质",
"start_offset": 26,
"end_offset": 29,
"label": "bod"
... |
（四）淤胆型肝炎可分为急性淤胆型和慢性淤胆型。 | [
{
"id": 0,
"entity": "淤胆型肝炎",
"start_offset": 3,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "急性淤胆型",
"start_offset": 11,
"end_offset": 16,
"label": "dis"
},
{
"id": 2,
"entity": "慢性淤胆型",
"start_offset": 17,
"end_offset": 22,
"label": "... |
临床表现同甲型淤胆型肝炎，但慢性淤胆型发生在慢性肝炎基础上，黄疸持续时间更长，预后较急性淤胆型差。 | [
{
"id": 0,
"entity": "甲型淤胆型肝炎",
"start_offset": 5,
"end_offset": 12,
"label": "dis"
},
{
"id": 1,
"entity": "慢性淤胆型",
"start_offset": 14,
"end_offset": 19,
"label": "dis"
},
{
"id": 2,
"entity": "慢性肝炎",
"start_offset": 22,
"end_offset": 26,
"label":... |
（五）肝炎肝硬化是慢性肝炎的发展结果。 | [
{
"id": 0,
"entity": "肝炎肝硬化",
"start_offset": 3,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "慢性肝炎",
"start_offset": 9,
"end_offset": 13,
"label": "dis"
}
] |
据肝活检报告，儿童HBV相关性肝硬化发生率为3.6%～32.6%，并可见于婴儿期。 | [
{
"id": 0,
"entity": "肝活检",
"start_offset": 1,
"end_offset": 4,
"label": "pro"
},
{
"id": 1,
"entity": "儿童HBV相关性肝硬化",
"start_offset": 7,
"end_offset": 18,
"label": "dis"
}
] |
肝活检有弥漫性肝纤维化及结节形成。 | [
{
"id": 0,
"entity": "肝活检",
"start_offset": 0,
"end_offset": 3,
"label": "pro"
},
{
"id": 1,
"entity": "肝",
"start_offset": 7,
"end_offset": 8,
"label": "bod"
},
{
"id": 2,
"entity": "弥漫性肝纤维化及结节形成",
"start_offset": 4,
"end_offset": 16,
"label": "sy... |
B超见肝脏缩小，表面凹凸不平，肝实质回声增强，呈结节状，门静脉和脾静脉内径增宽。 | [
{
"id": 0,
"entity": "B超",
"start_offset": 0,
"end_offset": 2,
"label": "pro"
},
{
"id": 1,
"entity": "肝脏",
"start_offset": 3,
"end_offset": 5,
"label": "bod"
},
{
"id": 2,
"entity": "肝脏缩小，表面凹凸不平",
"start_offset": 3,
"end_offset": 14,
"label": "sym... |
1.代偿性肝硬化指早期肝硬化。 | [
{
"id": 0,
"entity": "代偿性肝硬化",
"start_offset": 2,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "早期肝硬化",
"start_offset": 9,
"end_offset": 14,
"label": "dis"
}
] |
可有门静脉高压症，但无腹水、肝性脑病或上消化道出血。 | [
{
"id": 0,
"entity": "门静脉高压症",
"start_offset": 2,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "肝性脑病",
"start_offset": 14,
"end_offset": 18,
"label": "dis"
},
{
"id": 2,
"entity": "上消化道",
"start_offset": 19,
"end_offset": 23,
"label": "b... |
2.失代偿性肝硬化指中晚期肝硬化。 | [
{
"id": 0,
"entity": "失代偿性肝硬化",
"start_offset": 2,
"end_offset": 9,
"label": "dis"
},
{
"id": 1,
"entity": "中晚期肝硬化",
"start_offset": 10,
"end_offset": 16,
"label": "dis"
}
] |
有明显肝功能异常和失代偿征象。 | [
{
"id": 0,
"entity": "肝功能异常",
"start_offset": 3,
"end_offset": 8,
"label": "sym"
},
{
"id": 1,
"entity": "失代偿征象",
"start_offset": 9,
"end_offset": 14,
"label": "sym"
}
] |
可有腹水、肝性脑病及门脉高压症引起的侧支血管明显曲张或出血。 | [
{
"id": 0,
"entity": "腹水",
"start_offset": 2,
"end_offset": 4,
"label": "sym"
},
{
"id": 1,
"entity": "肝性脑病",
"start_offset": 5,
"end_offset": 9,
"label": "dis"
},
{
"id": 2,
"entity": "门脉高压症",
"start_offset": 10,
"end_offset": 15,
"label": "dis"
... |
【肝外损害】（一）肾脏损害1.乙型肝炎相关性肾炎多表现为膜性肾小球肾炎或肾病。 | [
{
"id": 0,
"entity": "肝",
"start_offset": 1,
"end_offset": 2,
"label": "bod"
},
{
"id": 1,
"entity": "肝外损害",
"start_offset": 1,
"end_offset": 5,
"label": "sym"
},
{
"id": 2,
"entity": "肾脏",
"start_offset": 9,
"end_offset": 11,
"label": "bod"
},
... |
肾组织免疫荧光检查有乙肝抗原、IgG、补体C3沉积。 | [
{
"id": 0,
"entity": "肾组织免疫荧光检查",
"start_offset": 0,
"end_offset": 9,
"label": "pro"
},
{
"id": 1,
"entity": "乙肝抗原、IgG、补体C3沉积",
"start_offset": 10,
"end_offset": 25,
"label": "sym"
}
] |
2.肾小管酸中毒慢性乙肝患者出现厌食、呕吐、多饮多尿、生长障碍；代谢性酸中毒伴碱性尿及相关电解质改变。 | [
{
"id": 0,
"entity": "肾小管酸中毒慢性乙肝",
"start_offset": 2,
"end_offset": 12,
"label": "dis"
},
{
"id": 1,
"entity": "厌食",
"start_offset": 16,
"end_offset": 18,
"label": "sym"
},
{
"id": 2,
"entity": "呕吐",
"start_offset": 19,
"end_offset": 21,
"label": "... |
（二）血液系统损害1.再生障碍性贫血各型肝炎时均可发生，治疗效果差，病死率高。 | [
{
"id": 0,
"entity": "血液系统",
"start_offset": 3,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "血液系统损害",
"start_offset": 3,
"end_offset": 9,
"label": "sym"
},
{
"id": 2,
"entity": "再生障碍性贫血",
"start_offset": 11,
"end_offset": 18,
"label": "... |
2.血小板减少性紫癜对治疗反应差，常伴抗心磷脂抗体阳性。 | [
{
"id": 0,
"entity": "血小板减少性紫癜",
"start_offset": 2,
"end_offset": 10,
"label": "dis"
},
{
"id": 1,
"entity": "抗心磷脂抗体",
"start_offset": 19,
"end_offset": 25,
"label": "bod"
},
{
"id": 2,
"entity": "抗心磷脂抗体阳性",
"start_offset": 19,
"end_offset": 27,
"l... |
（三）血清病样表现有皮疹、关节疼痛、短暂发热等。 | [
{
"id": 0,
"entity": "血清",
"start_offset": 3,
"end_offset": 5,
"label": "bod"
},
{
"id": 1,
"entity": "皮疹",
"start_offset": 10,
"end_offset": 12,
"label": "sym"
},
{
"id": 2,
"entity": "关节",
"start_offset": 13,
"end_offset": 15,
"label": "bod"
},... |
（四）婴儿丘疹样肢皮炎发生于婴儿HBV感染、HBsAg为ayw亚型者。 | [
{
"id": 0,
"entity": "婴儿丘疹样肢皮炎",
"start_offset": 3,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "婴儿HBV感染",
"start_offset": 14,
"end_offset": 21,
"label": "dis"
},
{
"id": 2,
"entity": "ayw亚型",
"start_offset": 28,
"end_offset": 33,
"lab... |
面部和四肢有非化脓性红色丘疹。 | [
{
"id": 0,
"entity": "面部",
"start_offset": 0,
"end_offset": 2,
"label": "bod"
},
{
"id": 1,
"entity": "四肢",
"start_offset": 3,
"end_offset": 5,
"label": "bod"
},
{
"id": 2,
"entity": "面部和四肢有非化脓性红色丘疹",
"start_offset": 0,
"end_offset": 14,
"label": "... |
病变皮肤的微血管壁有HBsAg、IgG、C3免疫复合物沉积。 | [
{
"id": 0,
"entity": "病变皮肤的微血管壁",
"start_offset": 0,
"end_offset": 9,
"label": "bod"
},
{
"id": 1,
"entity": "病变皮肤的微血管壁有HBsAg、IgG、C3免疫复合物沉积",
"start_offset": 0,
"end_offset": 29,
"label": "sym"
}
] |
【病原学诊断】（一）血清HBV标志物（HBVmarkers）检测（常用ELISA法）1.乙肝表面抗原（HBsAg）和表面抗体（抗HBs）HBsAg是HBV感染的标志，高滴度阳性提示有HBV复制。 | [
{
"id": 0,
"entity": "血清HBV标志物（HBVmarkers）检测",
"start_offset": 10,
"end_offset": 32,
"label": "pro"
},
{
"id": 1,
"entity": "ELISA法",
"start_offset": 35,
"end_offset": 41,
"label": "pro"
},
{
"id": 2,
"entity": "乙肝",
"start_offset": 44,
"end_offset": 4... |
抗HBs为保护性中和抗体，在乙肝恢复期或乙肝疫苗免疫后出现。 | [
{
"id": 0,
"entity": "乙肝",
"start_offset": 14,
"end_offset": 16,
"label": "dis"
},
{
"id": 1,
"entity": "乙肝疫苗",
"start_offset": 20,
"end_offset": 24,
"label": "dru"
}
] |
两者同时阳性见于疫苗免疫后HBV变异株感染。 | [
{
"id": 0,
"entity": "变异株感染",
"start_offset": 16,
"end_offset": 21,
"label": "dis"
}
] |
2.乙肝e抗原（HBeAg）和e抗体（抗HBe）HBeAg是HBV复制的标志。 | [
{
"id": 0,
"entity": "乙肝",
"start_offset": 2,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "e抗体",
"start_offset": 15,
"end_offset": 18,
"label": "bod"
},
{
"id": 2,
"entity": "抗HBe",
"start_offset": 19,
"end_offset": 23,
"label": "bod"
... |
HBeAg阴转和抗HBe出现表明病毒复制停止，见于：①急性感染恢复期；②慢性感染HBV非复制期；③HBV极低复制状态或慢性期pre-core基因突变时。 | [
{
"id": 0,
"entity": "抗HBe",
"start_offset": 8,
"end_offset": 12,
"label": "bod"
},
{
"id": 1,
"entity": "病毒",
"start_offset": 16,
"end_offset": 18,
"label": "mic"
},
{
"id": 2,
"entity": "慢性感染HBV",
"start_offset": 36,
"end_offset": 43,
"label": "d... |
两者不会同时阳性，同时持续阴性提示pre-core变异株感染。 | [
{
"id": 0,
"entity": "pre-core变异株感染",
"start_offset": 17,
"end_offset": 30,
"label": "dis"
}
] |
3.乙肝核心抗原（HBcAg）和核心抗体（抗HBc）HBcAg是HBV复制的直接标志。 | [
{
"id": 0,
"entity": "乙肝",
"start_offset": 2,
"end_offset": 4,
"label": "dis"
},
{
"id": 1,
"entity": "核心抗体",
"start_offset": 16,
"end_offset": 20,
"label": "bod"
},
{
"id": 2,
"entity": "抗HBc",
"start_offset": 21,
"end_offset": 25,
"label": "bod"
... |
抗HBcIgM亦是HBV复制标志，急性期呈高滴度阳性，慢性感染HBV复制期亦呈阳性，但滴度较低。 | [
{
"id": 0,
"entity": "抗HBcIgM",
"start_offset": 0,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "HBV",
"start_offset": 9,
"end_offset": 12,
"label": "mic"
},
{
"id": 2,
"entity": "高滴度阳性",
"start_offset": 21,
"end_offset": 26,
"label": "s... |
抗HBcIgG在HBV感染后常持续存在，高滴度阳性提示有HBV复制。 | [
{
"id": 0,
"entity": "抗HBcIgG",
"start_offset": 0,
"end_offset": 7,
"label": "mic"
},
{
"id": 1,
"entity": "HBV感染",
"start_offset": 8,
"end_offset": 13,
"label": "dis"
},
{
"id": 2,
"entity": "高滴度阳性",
"start_offset": 20,
"end_offset": 25,
"label": ... |
（二）血清HBVDNA是HBV复制的直接标志。 | [
{
"id": 0,
"entity": "血清HBVDNA",
"start_offset": 3,
"end_offset": 11,
"label": "bod"
},
{
"id": 1,
"entity": "HBV",
"start_offset": 12,
"end_offset": 15,
"label": "mic"
}
] |
可用PCR法进行定性或定量分析。 | [
{
"id": 0,
"entity": "PCR法",
"start_offset": 2,
"end_offset": 6,
"label": "pro"
}
] |
【预防】（一）乙肝疫苗乙肝疫苗是控制HBV感染的有效手段，除新生儿普种已纳入国家计划免疫外，其他易感人群，特别是儿童有条件时均应积极接种。 | [
{
"id": 0,
"entity": "乙肝疫苗",
"start_offset": 7,
"end_offset": 11,
"label": "dru"
},
{
"id": 1,
"entity": "乙肝疫苗",
"start_offset": 11,
"end_offset": 15,
"label": "dru"
},
{
"id": 2,
"entity": "HBV感染",
"start_offset": 18,
"end_offset": 23,
"label": "d... |
现采用重组基因疫苗。 | [
{
"id": 0,
"entity": "重组基因疫苗",
"start_offset": 3,
"end_offset": 9,
"label": "dru"
}
] |
注射部位以上臂三角肌内注射最佳。 | [
{
"id": 0,
"entity": "上臂三角肌内注射",
"start_offset": 5,
"end_offset": 13,
"label": "pro"
}
] |
2.加强和复种基础免疫后应强调抗HBs的检测。 | [
{
"id": 0,
"entity": "复种",
"start_offset": 5,
"end_offset": 7,
"label": "pro"
},
{
"id": 1,
"entity": "抗HBs的检测",
"start_offset": 15,
"end_offset": 22,
"label": "pro"
}
] |
产生有效抗HBs表明免疫成功，无抗HBs产生者应再次全程免疫，免疫成功后抗HBs水平下降或消失应加强免疫（单剂接种剂接种即可）。 | [
{
"id": 0,
"entity": "抗HBs",
"start_offset": 4,
"end_offset": 8,
"label": "bod"
},
{
"id": 1,
"entity": "抗HBs",
"start_offset": 16,
"end_offset": 20,
"label": "bod"
},
{
"id": 2,
"entity": "单剂接种",
"start_offset": 53,
"end_offset": 57,
"label": "pro... |
（二）乙肝高效免疫球蛋白（HBIG）高危新生儿（母亲HBsAg阳性，特别是伴HBeAg阳性者）生后12小时内肌内注射HBIG200U；单次急性接触HBV（如输血制品、意外污染针头刺伤等）的成人或儿童在接触后24小时内肌内注射HBIG400U，推荐使用2剂，间隔15天。 | [
{
"id": 0,
"entity": "乙肝高效免疫球蛋白",
"start_offset": 3,
"end_offset": 12,
"label": "dru"
},
{
"id": 1,
"entity": "HBIG",
"start_offset": 13,
"end_offset": 17,
"label": "dru"
},
{
"id": 2,
"entity": "肌内注射HBIG200U",
"start_offset": 54,
"end_offset": 66,
... |
接触HBV达7天或超过7天不应使用HBIG。 | [
{
"id": 0,
"entity": "HBV",
"start_offset": 2,
"end_offset": 5,
"label": "mic"
},
{
"id": 1,
"entity": "HBIG",
"start_offset": 17,
"end_offset": 21,
"label": "dru"
}
] |
HBIG与乙肝疫苗联合应用可更有效地阻断母婴传播HBV，即两者同时在不同部位注射时，200U的HBIG不足以干扰乙肝疫苗的免疫反应。 | [
{
"id": 0,
"entity": "HBIG",
"start_offset": 0,
"end_offset": 4,
"label": "dru"
},
{
"id": 1,
"entity": "乙肝疫苗",
"start_offset": 5,
"end_offset": 9,
"label": "dru"
},
{
"id": 2,
"entity": "HBV",
"start_offset": 24,
"end_offset": 27,
"label": "mic"
... |
【治疗】（一）一般治疗同其他肝炎，包括合理营养、适宜活动、保护肝细胞、改善肝功能、预防肝纤维化（常采用活血化瘀中药）、调整免疫和对症治疗等综合治疗措施。 | [
{
"id": 0,
"entity": "肝炎",
"start_offset": 14,
"end_offset": 16,
"label": "dis"
},
{
"id": 1,
"entity": "合理营养",
"start_offset": 19,
"end_offset": 23,
"label": "pro"
},
{
"id": 2,
"entity": "适宜活动",
"start_offset": 24,
"end_offset": 28,
"label": "pro... |
（二）抗病毒治疗其近期目标是抑制病毒增殖，改善症状和肝脏功能，减轻肝组织病变；远期目标是清除病毒，防止肝硬化和肝细胞癌的发生，提高生存率和改善生存质量。 | [
{
"id": 0,
"entity": "病毒",
"start_offset": 16,
"end_offset": 18,
"label": "mic"
},
{
"id": 1,
"entity": "肝脏",
"start_offset": 26,
"end_offset": 28,
"label": "bod"
},
{
"id": 2,
"entity": "肝组织",
"start_offset": 33,
"end_offset": 36,
"label": "bod"
... |
目前在世界范围批准治疗慢性乙肝的药物只有干扰素和拉米夫定两种。 | [
{
"id": 0,
"entity": "慢性乙肝",
"start_offset": 11,
"end_offset": 15,
"label": "dis"
},
{
"id": 1,
"entity": "干扰素",
"start_offset": 20,
"end_offset": 23,
"label": "dru"
},
{
"id": 2,
"entity": "拉米夫定",
"start_offset": 24,
"end_offset": 28,
"label": "dr... |
一般认为，对于无肝损害或轻微肝病的HBV感染者宜医学观察，不推荐治疗。 | [
{
"id": 0,
"entity": "肝",
"start_offset": 8,
"end_offset": 9,
"label": "bod"
},
{
"id": 1,
"entity": "轻微肝病",
"start_offset": 12,
"end_offset": 16,
"label": "dru"
},
{
"id": 2,
"entity": "HBV感染",
"start_offset": 17,
"end_offset": 22,
"label": "dis"
... |
可选用的治疗方法如下：1.干扰素α（IFN-α）血清HBVDNA＞106</sup>copies/ml伴ALT异常的慢性患者适合IFN-α治疗。 | [
{
"id": 0,
"entity": "干扰素α",
"start_offset": 13,
"end_offset": 17,
"label": "dru"
},
{
"id": 1,
"entity": "IFN-α",
"start_offset": 18,
"end_offset": 23,
"label": "dru"
},
{
"id": 2,
"entity": "血清HBVDNA",
"start_offset": 24,
"end_offset": 32,
"label... |
失代偿性肝硬化、患自身免疫性疾病或有重要脏器疾病者不宜使用。 | [
{
"id": 0,
"entity": "失代偿性肝硬化",
"start_offset": 0,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "自身免疫性疾病",
"start_offset": 9,
"end_offset": 16,
"label": "dis"
},
{
"id": 2,
"entity": "重要脏器疾病",
"start_offset": 18,
"end_offset": 24,
"label... |
儿童剂量尚未统一，推荐剂量为3MU/m2</sup>（成人推荐每次5MU），皮下或肌内注射，每周3次，疗程≥6个月。 | [
{
"id": 0,
"entity": "皮下或肌内注射",
"start_offset": 38,
"end_offset": 45,
"label": "pro"
}
] |
治疗初期常见发热等感冒样综合征，在晚间或睡眠前用药可减轻不适反应。 | [
{
"id": 0,
"entity": "发热",
"start_offset": 6,
"end_offset": 8,
"label": "sym"
},
{
"id": 1,
"entity": "感冒",
"start_offset": 9,
"end_offset": 11,
"label": "sym"
}
] |
粒细胞和血小板减少是常见的不良反应，前者经加服复方阿胶浆可获改善，当WBC计数＜3.0×109</sup>/L或粒细胞计数＜1.5×109</sup>/L或血小板计数＜40×109</sup>/L时应停药，一般可自行恢复，恢复后可重新治疗。 | [
{
"id": 0,
"entity": "粒细胞",
"start_offset": 0,
"end_offset": 3,
"label": "ite"
},
{
"id": 1,
"entity": "血小板",
"start_offset": 4,
"end_offset": 7,
"label": "ite"
},
{
"id": 2,
"entity": "粒细胞和血小板减少",
"start_offset": 0,
"end_offset": 9,
"label": "sym"... |
2.拉米呋定（lamivudine，LAM）为核苷类似物，适应证同IFN-α。 | [
{
"id": 0,
"entity": "拉米呋定",
"start_offset": 2,
"end_offset": 6,
"label": "dru"
},
{
"id": 1,
"entity": "lamivudine",
"start_offset": 7,
"end_offset": 17,
"label": "dru"
},
{
"id": 2,
"entity": "LAM",
"start_offset": 18,
"end_offset": 21,
"label": ... |
用药期间应监测肝功能和血常规，若服药6个月以上病情复发，应考虑发生HBV变异而停药。 | [
{
"id": 0,
"entity": "监测肝功能",
"start_offset": 5,
"end_offset": 10,
"label": "pro"
},
{
"id": 1,
"entity": "血常规",
"start_offset": 11,
"end_offset": 14,
"label": "pro"
},
{
"id": 2,
"entity": "HBV",
"start_offset": 33,
"end_offset": 36,
"label": "mic... |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.