病毒性肝炎慢性活动性病理诊断的量化指标

Numerical scoring system for assessing histological activity in chronic hepatitis

目的：通过对肝组织切片中各种基本病理变化分析，采用量化手段确定其在肝病诊断中的价值，建立肝脏病理量化诊断的标准。方法：选取基本病理变化１１ 项作为诊断的慢性指标，各赋于一定的分值，分值相加为慢性活动性指数，观察慢性肝炎肝组织切片７２２ 份，并与常规读片及 Ｋｎｏｄｅｌｌ Ｈ Ａ Ｉ评分系统对比，采用方差分析和ｑ 检验。结果：轻度慢性肝炎４０２ 例，中度慢性肝炎２１１ 例，重度慢性肝炎１０９ 例，三种疾病肝组织病理慢性活动性指数间差异均有显著性（ Ｐ＜ ０ ．０１） 。结论：指标应用方便，易于操作，观察全面细致，具有良好的区别性和可重复性。

Objective:To establish a numerical scoring system in characterizing the pathologic changes in liver biopsy of chronic viral hepatitis and to evaluate their significance in diagnosis.Methods:Classified the pathological changes often appeared in the chronic hepatitis into 11 categories.A definite score was given to each category,the essential index,and each category was subdivided into 3 grades.Added up the numerical scores of each case and the sum was the histological chronic activity index. Seven hundred twenty two patients with chronic hepatitis were studied,and compared with conventional readings and Knodell'HAI,calculated the results with F analysis and q test.Results:According to the conventional readings,402 cases belonged to mild,211 to middle and 109 to severe chronic hepatitis.The differences in histological chronic activity index among these 3 chronic hepatitis were significant.Conclusions:The histological chronic activity index can be used as an alternative or supplemental method to conventional or Knodell'HAI.