慢性活动性肝炎肝穿刺病理检查的重要意义

通过对93例各类乙型病毒性肝炎(HBV)的肝穿活检,探讨此项检查对病毒性肝炎分型的诊断价值。尤其是对慢性活动性肝炎(CAH),在确定诊断方面有着重要的临床意义。此型病人临床可表现为各型肝炎,最后经肝穿活检才得以确诊,提高了CAH的确诊率。

EVALUATION OF LIVER BIOPSY IN THE DIAGNOSIS OF CHRONIC ACITVE HEPATITIS

Liver biopsy in 93 patients withhepatitis B disclosed that clinical im-pression is not always in accordancewith pathological diagnosis. Most of the cases of chronic active hepatitis(CAH) were unrecognized clinically.Out of 24 cases in acute onset withouthepatitis history diagnosed as acutehepatitis (AH), 21 cases were CAH.Among five of seven cases clinicallydiagnosed as chronic persistent hepat-itis (CPH) were CAH. Twenty-sevenof 41 cases clinically diagnosed as CAHshowed typical lesion of cirrhosispathologically. Four of 11 cases clini-cally diagnosed as severe hepatitis withintense jaundice and noticeable digestivesymptom were CAH and were all cured.One case of CAH with moderate jaundicewas clinically misdiagnosed as cholesta-tic hepatitis. The clinical patterns ofCAH varied from mild to severe. Adefinite diagnosis can only be made byliver biopsy.