病毒性肝炎患者临终前临床与病理诊断对比分析

目的 :评价 1995年《病毒性肝炎防治方案 (试行 )》有关临床与病理诊断的一致性。方法 :以 5 1例死于病毒性肝炎患者的病理诊断为基础 ,对临床诊断各项生化指标进行对比分析。结果 :患者临终前各项生化指标中以凝血酶原活动度诊断价值较大 ,总胆红素、丙氨酸氨基转移酶其次 ,白蛋白、白球蛋白比例、γ 球蛋白鉴别诊断价值不大。以凝血酶原活动度低于 40 %作为诊断重型肝炎的必备条件 ,对急性重型肝炎、亚急性重型肝炎有较好的符合率 ,对慢性重型肝炎有2 5 % (5 / 2 0 )的漏诊率 ,并使 3 3 .3 % (7/ 2 1)非重型肝炎诊断为慢性重型肝炎。结论 :应对病毒性肝炎重型化指标作进一步的研究调整。

Contrast Analysis of the Clinical and Pathological Diagnosis of Virus Hepatitis in the Terminal Stage

Objective　In order to evaluate whether clinical diagnosis is consistent with pathological diagnosis in 《prevention and treatment to virus hepatitis(probation)》.Methods　According to the pathological diagnosis of 51 patients died of virus hepatitis,some sorts of biochemical indices in clinical diagnosis were analysed contrastly.Result　In these biochemical indies of dying patients,the prothrombin activity(PTA) was the most valubale in diagnosis;total bilimbin(TBil) and alanine trasaminas(ALT) were the second;albumin,albumin-globulin ratio and γ-globulin were the least useful.Using prothrombin activity less than 40% as the essential condition in the diagnosis of severe virus hepatitis,it matched acute and subacute virus hepatitis very well.25%(5/20) chronic severe virus hepatitis were missed diagnosis and 33.5%(7/21) no-severe virus hepatitis were mistaked for chronic severe hepatitis according to this standard.Conclusion　The biochemical indices of severe virus hepatitis should be studied and revised.