摘要
最近世界胃肠病大会国际工作小组提出对慢性肝炎分类以病因为基础,以组织学病变程度进行半定量分级及分期的建议,我们以院内外110例慢性乙型肝炎(CLH、CPH、轻型CAH、中型CAH各25例,重型CAH10例)的肝活检切片,用Knodell的组织学活动指数(HAI)评分系统及Scheuer的分级(G)、分期(S)标准二个方案计分,对比其优缺点,以确立我国慢性肝炎分类、分级分期标准。HAI及G、S的计分中均突出了碎屑坏死(PN)及桥接坏死(BN)在反映炎症活动程度中的重要性。由于HAI将纤维化的计分也归入炎症活动程度,结果依此计分110例各型积分间有重叠。排除纤维化后,各型间分值的序贯性较好。HAI方案对纤维化程度的划分不够细致。Scheuer将炎症活动度及纤维化分别以分级(G)及分期(S)表示,各按程度分为O-4级。以之将110例进行划分,CLH,CPH的炎症活动度及纤维化程度均较轻,位于G1,G2,SO-Sl;轻型CAH位于G2,Sl-S2;中型CAH位于G3,S2-S3;重型CAH位于G4,S3-S4。划分明确,同时分期还能反映病变发展阶段。所以我们建议以Scheuer方案为基础,参照我国的经验对分级标准予?
To
evaluate the application of the recommendation made by the
Intemational Working Party on the classification,grading and staging
of chronic hepatitis,liver biopsy specimen from 110 cases of HBV
chronic hepatitis were reviewed and studied. The histopathologic
features were assessed with three diagnostic system:HAI(Knodell)、
Scheuer′s creteria and the conventional Chinese creteria for
chronic hepatitis.HAI was useful in quantitative as-sessment of the
pathologic severity of the lesions,but much overlapping existed among
the scores for CLH,CPH and various types of CAH. In original HAI,
staging of fibrosis was inappropriately includedin the total score.
Scheuer′s creteria was good in distinction for various types
hepatitis and staging of fibrosis was separated from the score of
grading.A separate category for fibrosis is crucial for recognizing
the stage in the development of the disease process from chronic
hepatitis to cirrhosis. Basing on the above study,a proposal was
raised with regard to the revision of the Chinese diagnostic creteria
of chronic hepatitis.
出处
《肝脏病杂志》
CSCD
1995年第3期130-133,共4页
关键词
慢性
肝炎
分类
分级
分期
诊断
chronic hepatitis Classification
Histopathology