Desmet V J
MMW Munch Med Wochenschr. 1978 Nov 17;120(46):1523-30.
The concept of chronic hepatitis is very complex. There is no generally recognized definition and no agreement on the nomenclature. In more recent times a subdivision into chronic persisting (CPH) and chronic active (aggressive or progressive) hepatitis (cah) has been proposed. Morphologically CPH has a mononuclear inflammatory infiltration of the portal fields with preservation of the lobules. In positive hepatitis B CPH, orcein-positive milkglass-shaped hepatocytes and washed-out nuclei have recently been established by immunofluorescence. Periportal inflammation (piecemeal necrosis) is characteristic of CAH. Severe forms show hepatocytolysis and confluent necroses in addition. Since there is not always a sharp division between CPH and CAH, an unequivocal diagnosis of clinical, biochemical, serologic and immunological data is required.
慢性肝炎的概念非常复杂。目前尚无普遍认可的定义,对于命名也未达成共识。最近有人提出将其细分为慢性持续性(CPH)和慢性活动性(侵袭性或进行性)肝炎(CAH)。从形态学上看,CPH表现为汇管区单核细胞炎症浸润,小叶结构保留。在乙肝阳性的CPH中,最近通过免疫荧光法发现了orcein阳性的牛奶玻璃样肝细胞和核淡染。汇管区周围炎症(碎片状坏死)是CAH的特征。严重形式还表现为肝细胞溶解和融合性坏死。由于CPH和CAH之间并不总是有明确的区分,因此需要综合临床、生化、血清学和免疫学数据做出明确诊断。