慢性肝病临床与病理关系的对比研究

A comparable study on the relationship between clinical findings of chronic liver diseases and pathologic diagnosis

目的 探讨慢性肝病患者临床与病理学分级、分期的关系。方法 对 2 0 0例慢性肝病患者的临床表现、血清生化指标与病理学分级、分期进行对比分析。结果 患者的年龄、临床症状及体征积分数与病理分级、分期显著相关(P <0 .0 5 ) ;PLT、RBC、AST、PⅢNP与炎症程度有关 ;PGA指数、PGAA指数、A、A/G与炎症及纤维化均显著相关 ;透明质酸是反映慢性肝病炎症及纤维化严重程度的准确指标 ,血清纤维化指标的优化组合有提高准确性的趋势 ;病毒复制指标与炎症及纤维化未见相关。结论 慢性肝病临床与纤维化病理分级、分期有良好相关性 ,有助于肝纤维化的非创伤性诊断。

Objective To appraise the relationship between clinical findings of patients with chronic liver diseases and the grading and staging of hepatic pathology.Methods A comparable analysis was carried out in 200 patients with chronic liver diseases by comparing their clinical manifestations, serum markers of hepatic fibrosis with the findings of liver biopsy.Results It was revealed that age, index of symptomatology were obvious relevant to the pathologic grading and staging of pathology ( P <0.05). PLT, RBC, AST, PⅢNP were related more to the degree of inflammation. PGA, PGAA index, A, A/G were relevant to both inflammation and fibrosis. HA was an accurate variable for severity of hepatic inflammation and fibrosis, combined serum markers for fibrosis tended to increase the diagnostic accuracy emphasis should be made that viral replication markers were not relevant to the degree of inflammation and fibrosis. Conclusion There is good correlation between clinical findings and the pathologic grading and staging, which may aid in the noninvasive diagnosis of liver fibrosis.