重型肝炎的临床转归与诊断分型的再认识  

Reevaluation of the clinical outcome and the diagnostic typing criteria in patients with severe hepatitis

作　　者：彭劼[1] 李福山[1] 侯金林[1] 章廉[1] 骆抗先[1] 

机构地区：[1]第一军医大学南方医院感染内科,广东广州510515

出　　处：《临床肝胆病杂志》2003年第1期14-15,21,共3页Journal of Clinical Hepatology

摘　　要：通过317例重型肝炎的临床总结分析,探讨其临床特点及更合适的分型标准。采用回顾性调查病案,分析重型肝炎的临床特点及转归。慢性重型肝炎病例在重型肝炎中占83.9％。重型肝炎多发生于男性,占89.0％;多发生于20～60岁患者,占80.1％。重型肝炎各临床表型预后无性别差异,60岁以上年龄组的预后较其它年龄组差,但无统计学差异。亚急性重型肝炎和慢性重型肝炎中,分别有5.6％和19.9％病例既无脑病亦无腹水,非脑病型预后明显优于脑病型。现行的腹水型、脑病型分型方法存在一定局限性,建议将亚急性重型肝炎和慢性重型肝炎分成脑病型和非脑病型。重型肝炎的临床特点与转归的再认识,可望对临床工作起到一定的指导意义。To explore the clinical feature and the possibility of establishing more reasonable diagnostic typing criteria for patients with severe hepatitis (SH) through analyzing clinical data of 317 cases of SH. The clinical characteristics and outcome of SH were analyzed by studying cases retrospectively. Chronic severe hepatitis (CSH) made up 83.9% of total cases of SH. SH mostly occurred in male patients, about 89.0% ,and in 20 to 60 years old patients, about 80.1%. There were no significant difference in prognosis of SH in male patients compared with mat in female patients. The survival rate was lower in over 60 - year - old group compared with other age group, but no significant difference. About 5.6% cases of subacute severe hepatitis (SSH) and 21.4% CSH had neither ascites nor hepatic encephalapathy. The survival rate in the patients with hepatic encephalopathy was much lower than that without hepatic encephalopathy. The criteria of dividing SH into encephalopathy and ascites type recommended by Chinese Hepatology Association is not satisfactory when used in clinical cases, and we suggest dividing SSH and CSH into 2 types: with encephalopathy type and without encephalopathy type. Reevaluation of the clinical feature and outcome in patients with severe hepatitis may facilitate clinical works.

关 键 词：重型肝炎 临床转归 分型 诊断 预后 脑病型 非脑病型 

分 类 号：R512.6[医药卫生—内科学]