关注儿童病因不明严重急性肝炎全球暴发流行

毛青; 赵颂涛

doi:10.16016/j.2097-0927.202205084

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关注儿童病因不明严重急性肝炎全球暴发流行

专家述评 | 更新时间：2026-01-09

- 关注儿童病因不明严重急性肝炎全球暴发流行
- Concern over global outbreak of acute severe hepatitis of unknown etiology in children
- 陆军军医大学学报 2022年44卷第11期页码：1079-1086
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院感染病科，全军感染病研究所
- 作者简介：
  
  [毛青，博士，主任医师，教授，博士研究生导师，长江学者特聘教授。任中华医学会医学病毒学分会副主任委员和感染病学分会常务委员、中国医师协会感染科医师分会常务委员、解放军传染病专委会副主任委员、重庆市医学会感染病学分会主任委员，入选重庆市学术技术带头人和重庆英才名师名家。担任Gastroenterology审稿人、《中华实验和临床病毒学杂志》副主编及多家杂志编委。作为专家先后参与抗击非典、埃博拉和新冠疫情。先后主持了973计划课题、国家科技重大专项课题、国家科技支撑计划、国家自然科学基金等课题10余项。参与获得国家科技进步二等奖1项、军队科技进步二等奖2项、重庆市科技进步二等奖1项。主要从事病毒性肝炎和新发传染病防治方面的研究。E-mail: qingmao@tmmu.edu.cnMAO Qing, E-mail: qingmao@tmmu.edu.cn
  [赵颂涛，副主任医师，E-mail: zhaosongtao1995@163.comZHAO Songtao, E-mail: zhaosongtao1995@163.com
- 基金信息：
- DOI：10.16016/j.2097-0927.202205084
  中图分类号： R512.6; R183
- 收稿：2022-05-16，
  
  修回：2022-05-19，
  
  纸质出版：2022-06-15
- 稿件说明：
移动端阅览
毛青, 赵颂涛. 关注儿童病因不明严重急性肝炎全球暴发流行[J]. 陆军军医大学学报, 2022,44(11):1079-1086.

Qing MAO, Songtao ZHAO. Concern over global outbreak of acute severe hepatitis of unknown etiology in children[J]. Journal of Army Medical University, 2022, 44(11): 1079-1086.
毛青, 赵颂涛. 关注儿童病因不明严重急性肝炎全球暴发流行[J]. 陆军军医大学学报, 2022,44(11):1079-1086. DOI： 10.16016/j.2097-0927.202205084.

Qing MAO, Songtao ZHAO. Concern over global outbreak of acute severe hepatitis of unknown etiology in children[J]. Journal of Army Medical University, 2022, 44(11): 1079-1086. DOI： 10.16016/j.2097-0927.202205084.

摘要

儿童病因不明严重急性肝炎是在新型冠状病毒肺炎全球大流行期间突然出现的一种病因不明的儿童肝脏疾病。自2022年4月初首次报道以来，已累及全球20多个国家，病例数达450例左右，以欧洲、北美洲为主，我国目前尚无类似病例报道。该病多发于5岁以下儿童，疾病特征主要为黄疸、转氨酶升高等肝病表现，呼吸道症状少见，少数病例发展为肝衰竭，需进行肝移植，大部分病例预后较好。目前考虑为感染所致，但具体病原体尚不明确，较多病例在血中检测到腺病毒，需考虑腺病毒感染所致的可能；及缺少驯化免疫、新冠肺炎后炎症持续等因素。该病无人际间传播证据，传染性较低，但需警惕新型冠状病毒肺炎仍处于高水平流行阶段的国家暴发大流行的可能；手卫生和呼吸道防护可能降低发病风险。本文就此病的流行病学及临床特征进行概述，并对疾病性质、病因及传播风险进行分析，旨在提供对此病临床诊治的最新认识。

Abstract

Acute severe hepatitis in children of unknown cause is a childhood liver disease of unknown etiology that emerged suddenly during the global pandemic of coronavirus disease 2019. Since it was reported in early April 2022

it has involved more than 20 countries around the world with about 450 cases

mainly in Europe and North America

and no similar case has been reported in China. The disease occurs mostly in children under 5 years of age and is characterized mainly by liver disease manifestations such as jaundice and elevated transaminases

with rare respiratory symptoms; a few cases develop into liver failure and need liver transplantation

and most cases have a good prognosis. The disease is currently considered to be caused by infection

but the exact pathogen remains unclear. Adenovirus is detected in blood in many cases

so the possibility of infection caused by adenovirus should be considered; and factors such as lack of trained immunity and persistent inflammatory in children with COVID-19 should also be considered. The disease is no evidence of interpersonal transmission

infectivity is low

but the possibility of a pandemic outbreak in countries with a high prevalence of COVID-2019 needs to be guarded against; hand hygiene and respiratory protection may reduce the risk of morbidity. This article provides an overview of the epidemiological and clinical features of the disease and analyzes its nature

etiology and transmission risk in order to provide updated awareness of its clinical diagnosis and treatment.

关键词

Keywords

references

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