慢性乙型肝炎分级分期动态变化的随访观察

Histopathological and follow up observation on developmental changes of grading and staging of chronic hepatitis B

目的观察慢性乙型肝炎分级分期病变的动态变化。方法用随访的肝活检方法，对１０３例乙型肝炎患者首、末２次肝活检标本作了分级（Ｇ）和分期（Ｓ）病变的动态观察。结果在慢性（包括肝硬变）期Ｇ病变好转者占５９％，加重占１６％，与Ｇ相比较，Ｓ病变好转者占４０％（Ｐ＜０．０１），加重者占３８％（Ｐ＜０．００１）。结论在乙型肝炎的病程中，肝实质炎症坏死较易修复，而增生的纤维组织降解则较慢，３８％患者有恶化趋势。在急性期Ｇ肝细胞坏死程度最有预报价值。

Objective To observe the dynamic changes of grading (G) and staging (S) of hepatitis B. Methods We studied the original and final liver biopsies from 103 cases of patients with chronic hepatitis B, making histopathological and follow up observations on dynamic changes of G and S. Results In the chronic (including cirrhosis) stage of hepatitis B, the pathological change degrees of G which took a better turn occupied 59% (61/103) and the proportion of aggravation cases was 16% (16/103); Comparing with it, that of S were 40% and 38%, respectively ( P <0.001).Conclusion The inflammatory necrosis in the liver tissues were easy to be repaired, whereas the proliferative fiber tissues degraded slowly. The state of illness aggravated in 38% of the patients with hepatitis B. In acute stage of hepatitis B, the degrees of hepatocellular necrosis were of great value.