慢性病毒性肝炎病理分型的探讨

目的探讨慢性病毒性肝炎病理新旧分类方案的优缺点。方法对749例经肝活检确诊的慢性肝炎肝组织切片采用叨年（上海）方案和95年（北京）方案进行对照观察。结果炎症分级（G）显示：G1～G2主要是CPH和轻度CAH的轻、中、重三个亚型与G2、G3、G4对应。纤维化分期（S）显示：CPH分布于S1～S2，CAH分布于S2～S1，S1共407例，其中CPH和CAH各占50％。G3、G4共280例在S2、S3、S4中所占比例分别为35％、27％和22％。结论新分类法不易区别CPH与轻度CAH。炎症程度与纤维化程度不呈正比，轻度慢性肝炎一型中包括了原CPH和轻度CAH，建议将此型按病变程度分为A、B两型。

COMPARISON BETWEEN THE NEW AND OLD CLASSIFICATIONS OF CHRONIC VIRAL HEPATITIS IN 749 CASES

To explore the advantages and disadvantages of the old and new pathological grading projects of chronic viral hepatitis. Method: The project made in Shanghai in 1990 and that in Beijing in 1995 werecompared in observing liver tissue slices from 749 patients with chronic virus hepatitis diagnosed by liver biopsy. Re sults: Inflamation grading showed that G1~G2 were mainly CPH; and mild moderate and sereve types of CAH corre sponded to G2,G3 and G4. The fibrosis grading were that CPH were among S1 ~ S2 and CAH were among S2~S4There were 407 cases at S1, among which both CPH and CAH were 50%. There were 280 cases at G3 and G4, whichwere 35%, 27% and 22% for S2S3 and S4, respectively. Conclusion: The fibrosis can not distinguish CPH from mildCAH. The degree of inflammation isn't direct proportion to that of fibrsis. The gype of mild chronic hepatitis in cludes CPH and mild CAH, which is suggested to be classified into A and B subtypes according to pathologic degree.