慢性肝炎炎症活动度及纤维化程度计分方案

A SEMIQUANTITATIVE SCORING SYSTEM FOR ASSESSMENT OF HEPATIC INFLAMMATION AND FIBROSIS IN CHRONIC VIRAL HEPATITIS

目的为便于统计、分析、比较，制定一个合理的慢性肝炎炎症活动度及纤维化程度的半定量计分方案。方法以Ｋｎｏｄｅｌ的炎症活动度指数及Ｃｈｅｖａｌｉｅｒ的纤维化半定量计分方案为基础，进行修改。应用近期系列肝穿刺标本分析验证修改后方案的适用性。结果①制定了慢性肝炎半定量计分方案及计算公式；②９６例慢性肝炎炎症活动度和纤维化程度计分结果与分级分期明显相关，相关系数分别为０９６３和０８７４（Ｐ＜００５）；③观察对比了３４例慢性乙型肝炎治疗前后各项病变的计分，证明该计分方案能较好地反映病变程度，便于疗效统计分析比较；量化数值能反映出同一级／期内病变程度差异。结论慢性肝炎计分方案，能较好地反映病变程度，特别适用于疗效的统计、分析、比较。

Objective To establish a semiquantitative scoring system for assessment of the severity of inflammation and fibrosis in chronic viral hepatitis patients. Methods A careful study was done to assess the histopathological features of the liver specimen of 92 patients with chronic viral hepatitis and early cirrhosis and the double liver specimen of 34 cases biopsied before and after treatment. Assessment of inflammation was made on the basis of HAI of Knodell, and fibrosis on the basis of Chevallier's syster with the author's modifications. Results 1) A semiquantitative scoring system was established. 2) The scores obtained were well correlated with the grading(G) and staging (S) of the liver pathology, r being 0 963 and 0 874(P<0 05) respectively. 3) Within the same S or G, scores of the pre- and post-treatment of the same patient was in good accordance with the improvement or worsening Conclusion The newly modified semiquantitative scoring system is useful for the evaluation of the severity the inflammation and fibrosis for HBV-related hepatitis and cirrhosis.