重型病毒性肝炎的病理、临床和实验室相关性探讨  

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

作　　者：孟庆华[1] 刘德恭[1] 向海平[1] 

机构地区：[1]北京佑安医院首都医科大学传染病与寄虫病学教研室,北京100054

出　　处：《中华实验和临床病毒学杂志》2001年第2期143-146,共4页Chinese Journal of Experimental and Clinical Virology

摘　　要：目的　分析 6 2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EXCEL 2 0 0 0软件对北京佑安医院 2 4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 0 0 5 ;肝性脑病的发病率分别为 10 0 %和为 6 6 7%。肝性脑病Ⅴ度昏迷的发病率分别为 6 9 3%和 33 3% ,P <0 0 1;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。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.

关 键 词：急性重型肝炎 亚急性重型肝炎 病理 凝血酶原活动度 胆固醇 

分 类 号：R512.6[医药卫生—内科学]