关键词: 肝炎，病毒性，人/诊断，病因学;急性病;成本及成本分析

    摘 要:目的 探讨急性病毒性肝炎病原学分型诊断最优策略. 方法 收集中国生物医学文摘(CBMD)1987/1999的所有相关文献，进行系统综述、成本效益和灵敏度分析. 结果 以HAV→HBV→HEV→HCV分型策略进行分型诊断的成本效益比(CER)17.9，HAV→HBV→HCV→HEV分型策略的CER为18.7，HBV→HAV→HCV→HEV CER为19.0，其余策略均大于20.年龄和试剂盒价格对分型策略影响不大.但如果乙肝病例占总病例的48.3%时，策略HBV→HAV→HEV→HCV的CER(15.1)最低. 结论 甲、乙、丙、戊型肝炎同时检测成本较高，策略HAV→HBV→HEV→HCV是最佳策略，但乙型肝炎病例占48.3%以上时，策略HBV→HAV→HEV→HCV为最佳.

    Most effective etiologic diagnosis strategy of acute viral hepatitis in China

    LI Wen-Bin，YAN Yong-Ping，SHAO Zhong-Jun，ZHANG Zhi-Ying，XU De-Zhong

    Department of Epidemiology，Faculty of Preventive Medicine，Fourth Military Medical University，Xi'an710033，China

    Keywords:hepatitis，viral，human/diagnosis;etiology;a-cute disease;costs and cost analysis

    Abstract:AIM To seek the most effective etiologic diagno-sis strategy of acute viral hepatitis in China.METHODS We collected all of related literatures in Chinese Biological Medicine Digest(CBMD)from1987to1999.Then systemat-ic review，cost-effectiveness and sensitivity analysis were em┐ployed.RESULTS Cost-effectiveness ratio(CER)value was17.9in the diagnosis strategy with the sequence of hepatitis A virus(HAV) ......