慢性病毒性肝炎分类方案的探讨─附316例肝穿病理分析

Assessment of a new classification of chronic hepatitis from pathological analysis of 316 cases

本文介绍了新近Ｓｃｈｅｕｅｒ提出的慢性肝炎病理分级、分期标准，为与国内分型标准相对比，我们用二个标准观察了我院１０年中３１６例慢性肝炎肝穿切片，探讨了５２例乙肝病变活动性与病毒复制的关系，并分析了１０例２次肝穿的病变转化。结果表明，（１）Ｓｃｈｅｕｅｒ分类的病变分级标准能较好地反映炎症活动程度，与ＣＰＨ及ＣＡＨ分型的病变程度划分基本一致；其纤维化分期还较好地反映了肝脏损伤的慢性程度。（２）炎症活动程度与病毒的复制状态有关。（３）ＣＡＨ、ＣＰＨ可以相互转化。通过对比，我们认为，Ｓｃｈｅｕｅｒ分类对慢性肝炎病变的评价较为客观、全面。

To assess Scheuer's classification of chronic hepatitis and compare it with the conventional classification, we reviewed the slides of liver biopsies from 316 cases of chronic hepatitis of our hospital in the past ten years. Correlation between virus replication markers and pathological activity were studied in 52 cases. Repeated biopsies were done in 10. Their dynamical changes were carefully analyzed. The results showed that (1) Scheuer's classification is useful and valuable in defining the inflammatory activity, the grading of which seems to be comparable with that of CPH and CAH. The classification of fibrosis into different stages serves as a good marker of the chronicity of liver injury ; (2) the activity of inflammation is well correlated with the virus replication rnarkers ; (3) CPH and CAH are inter-changeable. Basing on our data, we agree with that Scheuer's classification is a new and acceptable diagnostic creteria for assessment of liver injury in chronic hepatitis.