248例慢性病毒性肝炎组织病理与临床分析

Clinical and Pathological Analysis of Chronic Viral Hepatitis

目的分析比较慢性病毒性肝炎的组织病理及临床资料特点。方法选择248例进行过肝组织病理活检的慢性病毒性肝炎患者,按现行病毒性肝炎诊断标准分别作出临床诊断与病理诊断,比较两者诊断的一致性。结果临床诊断为慢性肝炎轻度的慢性病毒性肝炎,其临床诊断与病理诊断符合率最好,为90.7%。临床诊断为慢性肝炎中度的与病理诊断的符合率为76.6%,有部分慢性肝炎中度的患者已发展至肝硬化。肝硬化患者的临床诊断与病理诊断符合率为84.8%,临床诊断为慢性肝炎重度患者,其临床诊断与病理诊断符合率较差,为50%。临床诊断与病理诊断的总体符合率为78.6%。结论临床诊断标准对慢性肝炎的诊断有指导意义,但仍不能完全客观反映肝脏的实际状况,必要时应临床诊断与病理诊断相结合。

Objective To compare the characteristics of clinical diagnosis and pathological diagnosis in patients with chronic viral hepatitis. Methods The liver biopsy was performed in 248 patients with chronic viral hepatitis. Clinical diagnosis and the pathological diagnosis of these patients were made respectively according the criteria of chronic hepatitis diagnosis. Results The clinical diagnosis was coincided with the pathological diagnosis in 90.7% patients with mild chronic viral hepatitis light, in 76.6% patients with moderate chronic viral hepatitis, in 80.8% patients with liver cirrhosis, and in 78.6% of all the patients with chronic hepatitis. Conclusion The clinical diagnosis criteria of chronic hepatitis are useful, but the error rate is nearly 20%, compared with the pathological diagnosis. The accurate diagnosis should be made by combining clinical and pathological diagnosis.