小儿肝炎后肝硬化38例回顾性分析

RETROSPECTIVE ANALYSIS OF 38 CHILDREN WITH POST-HEPATITIS CIRRHOSIS

对本院３５ａ来经病理证实的３８例小儿肝炎后肝硬化进行了回顾性研究。病例年龄２个月至１４岁，平均６．０（±４．２）岁，小于１岁者占１８．４％。男女之比为１．４：１。在肝穿刺证实的小儿慢性肝病中占１１．５％，在小儿尸解病例中占０．４％。１例有急性乙肝病史患儿，发病５个月肝穿刺证实为早期肝硬化。肝脾肿大突出，但无早期诊断意义。血免疫球蛋白明显升高，补体Ｃ３普遍降低。血清乙肝病毒标记物（ＨＢＶＭ）总阳性率７２．２％。可见小儿肝炎后肝硬化并不少见，且发病早、发展快，主要为乙肝后肝硬化。

We retrospectively analysed 38 children with post-hepatitis cirrhosis confirmed by histodiagnosis during 1956～1991 in our hospital in order to determine the status of post-hepatitis cirrhosis in children and its clinical features.The mean age of these patients was 6.0(±4.2) years(from 2 months to 14 years),and 7(18.4%)of them were less than one year old.The male-female ratio was 1.4:1.0.4% of autopsies and 11.5% of chronic liver diseases diagnosed by liver puncture were post-hepatitis cirrhosis.One case had developed to early cirrhosis five months after acute hepatitis B.Hepatosplenomegaly was found in most of the patients,but less useful for early diagnosis.Hyperimmunoglobulinemia and low C3 were common, and the total positive rate of serum HBVM(Hepatitis B Virus Marker)was 72.2%.These results suggest that post-heptitis cirrhosis isn't rare in children,and can even be found in baby no more than two months old and may mainly originates from hepatitis B.