慢性肝炎213例临床病理分类探讨

ASSESSMENT OF SCHEUER'S CLASSIFICATION OF 213 CASES OF CHRONIC HEPATITIS

应用传统分类法及Ｓｃｈｅｕｅｒ分类法观察２１３例慢性肝炎的肝穿病理切片，共２６０例次。结果显示，Ｓｃｈｅｕｅｒ分类法与传统分类法基本一致。但对反映病变程度，动态观察病情、指导治疗等方面优于传统分类法；其病理分级与病人血清胆红素（ＳＢ）、丙氨酸转氨酶（ＡＬＴ）有关，与病毒复制关系不明显；分期与病人蛋白代谢、慢性肝病体征等有关。４７例病人２次肝穿病理变化显示，其炎症活动度的恢复较纤维化恢复快。

To assess Scheuer's classification of chronic hepatitis and compare it with the conventional classification,we reviewed 260 slides of liver biopsies from 213 cases of chronic hepatitis in our hospital(repeated biopsies were done in 47).The results showed that (1)compared with the conventional classification, Scheuer's classification was better in defining the inflammatory activity,dynamic observation of pathological changes and guiding of treatment;(2)the grading of Scheuer's classification was well correlated with serum total bilirubin (SB)and analine aminotransferase (ALT),but seemed not to be correlated with the virus replication markers;(3) albumin/globulin ratio,γ globulin and chronic hepatic signs were correlated with the stage.Dynamic pathological changes of 47 repeated liver biopsies showed that the recovery of inflammatory activity preceded that of fibrosis.