慢性病毒性肝炎不同分级分期方法的探讨

A comparative study in different grading and staging classification of chronic hepatitis B

探讨慢性肝炎不同的分级分期方案的应用价值．方法乙型肝炎患者７６例，对首末２次随访的肝组织标本，按照４种不同的慢性肝炎分级分期标准，进行了比较研究．结果Ｋｎｏｄｅｌ分级较Ｓｃｈｅｕｅｒ分级细，能够反应肝炎坏死程度的细微变化；Ｓｃｈｅｕｅｒ分期较Ｋｎｏｄｅｌ分期好，但将可能的和明确的肝硬变（ＬＣ）同归Ｓ４欠妥，我国分期修改了这一不足，作者分期量化较充分（０～１０），可根据肝脏增生的纤维组织类型预测可否向ＬＣ发展，提供分值可能更有价值．结论作者分期量化较充分，可预测肝硬变的发展．

IM To study the value of different grading and staging classification of chronic hepatitis. METHODS According to different grading and staging standards for chronic hepatitis, the liver biopies followed up for more than 2 times were compared in 76 cases of different types of hepatitis B. RESULTS Knodell′s grading was more in detail than Scheuer′s, for it could reflect the specific changes in the degree of degenerative necrosis and inflammation of the liver. Although Scheuer′s staging was more definite than Knodell′s, it was not appropriate to classify both the probable and definite cirrhosis into S4. Our staging has remedied this defect, it was more sufficient in quantitative changes (score 0 to 10). CONCLUSION Our classification may be an effective tool in the prediction of histological outcome of hepatitis B.