Graudal N, Leth P, Mårbjerg L, Galløe A M
Department of Internal Medicine B, Bispebjerg Hospital, Copenhagen, Denmark.
J Intern Med. 1991 Aug;230(2):165-71. doi: 10.1111/j.1365-2796.1991.tb00425.x.
In 4929 consecutive autopsies performed during a period of 4 years, 222 cases (4.5%) of cirrhosis were found, of which 149 (3%) were detected while the patients were alive (diagnosed cirrhosis) and 73 (1.5%) were not detected while the patients were living (undiagnosed cirrhosis). Fifty-three of the 73 undiagnosed patients appeared to be completely without signs of cirrhosis (silent cirrhosis). In the diagnosed group, 70% of patients died from hepatic causes, in contrast to 16% in the undiagnosed group. At autopsy, the following complications of cirrhosis were found more frequently in the diagnosed group than in the undiagnosed group: ascites (41% vs. 8%), oesophageal varices (44% vs. 10%), splenomegaly (52% vs. 29%). The prevalence of hepatocellular carcinoma did not differ significantly in the two groups (12% vs. 8%). It is concluded that cirrhosis without obvious signs occurs relatively frequently, and that no sensitive non-invasive screening methods are available at present.
在4年期间进行的4929例连续尸检中，发现222例（4.5%）肝硬化病例，其中149例（3%）在患者生前被检测到（诊断为肝硬化），73例（1.5%）在患者生前未被检测到（未诊断的肝硬化）。73例未诊断患者中有53例似乎完全没有肝硬化迹象（隐匿性肝硬化）。在诊断组中，70%的患者死于肝脏原因，而未诊断组为16%。尸检时，诊断组肝硬化的以下并发症比未诊断组更常见：腹水（41%对8%）、食管静脉曲张（44%对10%）、脾肿大（52%对29%）。两组肝细胞癌的患病率无显著差异（12%对8%）。结论是，无明显体征的肝硬化相对常见，目前尚无敏感的非侵入性筛查方法。
