548例代偿期肝硬化临床与病理研究

目的探讨代偿期肝硬化的临床与病理的关系,肝硬化病理特点发生发展过程的动态变化,以及对泰来肽治疗的反应。方法对近30年来本科住院治疗的代偿期肝硬化548例(均经肝活检证实)进行了重复肝活检,其中325例2次以上。肝组织切片进行HE染色和改良网织染色检查。肝组织内病毒抗原采用免疫组织化学检查,血清病毒标志物和病毒基因分别采用ELISA法和PCR法检查。所有病例住院治疗3～18个月,平均6个月。绝大多数病例采用泰来肽治疗,2～8ml每日1次注射,部分病例采用泰来肽与拉米夫定联合治疗,疗程均为3个月。结果临床治愈72.9%,基本治愈11.4%,好转14.3%,ALT复常率98.6%,蛋白代谢复常率68.6%,肝组织病理前后两次对照,大部分病例显著进步,由肝硬化逆转为中度和轻度慢性肝炎患者分别占68.4%和34.6%,血清HBsAg和HBeAg阴转率分别为7.5%和51.2%。结论肝硬化的病理特征经适当治疗可以逆转,泰来肽具有良好的抗炎和抗纤维化作用。

Clinical and pathologic study on compensated liver cirrhosis of 548 cases

Objective To evaluate the relationship between the clinical manifestations and hepatopathol-ogy of liver cirrhosis and treatment results with Tailai peptide,548patients with liver cirrhosis were studied.Methods All the studied patients were given liver biopsies,325more than two times.Liver tis-sues were studied with HE and Foot silver stains,HBVM and HBV DNA were detected with ELISA and PCR respectively.All the patients were treated in hospital for3to18months,6months on an average.Most of them were treated with Tailai peptide2to8ml i.monce daily,the others combined with lamivu-dine for3months.Results The studies showed that the clinical recovery rate was72.9%,ALT normal-ization rate98.6%and A/G improvement rate68.6%.The hepatopathology of most patients were im-proved obviously,disappearance of pseudolobules and intralobular fibrous septum to chronic active or per-sistent hepatitis was68.4%and34.6%respectively.Seroconversion rate of HBeAg and HBsAg was51.2%and7.5%respectively.Conclusions The pathological morphology of compensated liver cirrhosis can be reversed with correct effective treatment.Tailai peptide has excellent effects in treating liver cirrhosis