重型病毒性肝炎的病理、临床和实验室相关性探讨

目的分析62例急性重型肝炎(ASH)和72例亚急性重型肝炎(SSH)的病理、临床和实验室检查特点，以提高对重型肝炎的诊断正确率，指导临床早期、积极治疗，提高存活率。方法　应用EXCEL2000软件对北京佑安医院24年中收治的有肝组织病理结果的ASH和SSH患者的临床特点进行分析。结果　ASH和SSH比较，发病年龄分别为40±13岁和44±15岁，P<0.005；肝性脑病的发病率分别为100%和为66.7%。肝性脑病Ⅴ度昏迷的发病率分别为69.3%和33.3%，P<0.01；肝脏重量二组均减轻；腹水的发生率分别为35.5%和76.4%；TBiL、PTA、NH3、WBC二者比较差异均有显著性，胆固醇均降低，且降低的数值与TBiL、PTA、Cho变化，与疾病发生、发展密切相关。结论　肝性脑病是ASH必须指标之一；TBiL、PTA、Cho与疾病变化密切相关，是重型肝炎实验室诊断的必须指标，也是临床病情变化及预后监测的必须指标之一。

An inquire into the relationship among pathology, clinic and laboratory indexes of the severe viral hepatitis

OBJECTIVE: This study was to analyze the relationship among pathology, clinic and laboratory indexes in 62 cases of the acute severe hepatitis (ASH) and 72 cases of the subacute severe hepatitis(SSH) to offer a correct diagnosis and recognition of the disease. METHODS: A total of 134 severe hepatitis cases with confirmed pathology treated in a course of 24 years were analyzed by programs of EXCEL 2000. RESULTS: When compared ASH with SSH, the onset of the age were 40 +/- 13 years old and 44 +/- 15 years old, P < 0.05, the rates of hepatitis coma were 100% and 66.7% respectively. The liver weight of all the cases decreased. The tests of TBiL, PTA, Cho, NH3 and WBC between ASH and SSH had significant differences. CONCLUSION: Hepatic encephalopathy is a necessary criterion for ASH. The TBiL, PTA and Cho changes are closely related with severe viral hepatitis, they not only are the essential laboratory indexes but also the indispensable factors for disease development and prognosis of severe viral hepatitis.