Chen T J, Liaw Y F
Department of Pathology, Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
Liver. 1988 Feb;8(1):10-6. doi: 10.1111/j.1600-0676.1988.tb00960.x.
A histopathologic follow-up study was conducted in 207 consecutive patients to examine the prognostic significance of bridging hepatic necrosis (BHN) in chronic type B hepatitis. One hundred and eight patients showed BHN and the other 99 intralobular spotty necrosis (SN) on initial biopsy. A higher proportion of patients with BHN healed (45.4% vs 26.4%) or developed cirrhosis (18.3% vs 3%) than the patients with SN. In contrast, intralobular inflammation persisted or recurred more frequently in the SN than in the BHN group (40.4% vs 5.6%). These figures were statistically significant (P less than 0.001). Alternatively, 87% of the patients who developed cirrhosis had had BHN as their initial histologic presentations. The estimated relative risk of cirrhotic progression for the BHN group compared to the SN group was 4:1. We conclude that BHN is a paradoxical prognostic factor, either for healing, or cirrhotic progression.
对207例连续性慢性乙型肝炎患者进行了组织病理学随访研究，以探讨桥接性肝坏死（BHN）在慢性乙型肝炎中的预后意义。108例患者初次活检显示为BHN，另外99例为小叶内点状坏死（SN）。与SN患者相比，BHN患者愈合（45.4%对26.4%）或发展为肝硬化（18.3%对3%）的比例更高。相反，SN组小叶内炎症持续或复发的频率高于BHN组（40.4%对5.6%）。这些数据具有统计学意义（P<0.001）。另外，87%发展为肝硬化的患者最初的组织学表现为BHN。BHN组与SN组相比，肝硬化进展的估计相对风险为4:1。我们得出结论，BHN是一个矛盾的预后因素，无论是对于愈合还是肝硬化进展。
