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慢性肝炎——687例临床病理研究(作者译)

[Chronic hepatitis--clinicopathological studies of 687 cases (author's transl)].

作者信息

Teshima S, Aizawa M, Naka A, Sato F

出版信息

Hokkaido Igaku Zasshi. 1979 Jan;54(1):39-48.

PMID:468098
Abstract

Chronic hepatitis is one of liver diseases with arguments from the clinical and histopathological aspects. Histopathological examinations were made on 687 biopsy cases clinically diagnosed as chronic hepatitis. Histopathological classification was based on our own criteria by referring to discussions in the series of Inuyama symposia on hepattis and others. The correlation between histological diagnosis and clinical data was also examined. Histopathological diagnoses made of the 687 cases were classified as follows; normal liver or liver with no pathognomonic changes of 77 cases (11.2%), non-specific reactive hepatitis of 56 cases (8.0%), viral hepatitis of 488 cases (71.0%), alcoholic hepatitis of 25 cases (3.6%), fatty liver of 23 cases (3.3%), massive liver necrosis of 3 cases, liver fibrosis of 2 cases, congestive liver of 1 case, and unclassified 12 cases due to inadequate specimens or other reasons. Among 488 viral hepatitis cases, histological stages were as follows; acute hepatitis (38 cases, 7.8%), persistent hepatitis (23 cases, 4.7%), chronic inactive hepatitis (142 cases, 29.1%), chronic active hepatitis (165 cases, 33.8%), chronic hepatitis with subloblar necrosis (33 cases, 6.8%), precirrhosis (51 cases, 10.5%), cirrhosis (27 cases, 5.5%). The relationship between histological aspects and clinical features was discussed by sex, age, and others. Of 41 follow up cases, significant values of histological type, presence of HB ag., or alcoholic were discussed as for the causative factors evolving liver cirrhosis.

摘要

慢性肝炎是一种在临床和组织病理学方面存在争议的肝脏疾病。对687例临床诊断为慢性肝炎的活检病例进行了组织病理学检查。组织病理学分类参照犬山肝炎专题讨论会等系列讨论中的标准,并依据我们自己的标准进行。同时还研究了组织学诊断与临床数据之间的相关性。687例病例的组织病理学诊断分类如下:正常肝脏或无特征性病变的肝脏77例(11.2%),非特异性反应性肝炎56例(8.0%),病毒性肝炎488例(71.0%),酒精性肝炎25例(3.6%),脂肪肝23例(3.3%),大块肝坏死3例,肝纤维化2例,充血性肝1例,因标本不足或其他原因未分类12例。在488例病毒性肝炎病例中,组织学分期如下:急性肝炎(38例,7.8%),持续性肝炎(23例,4.7%),慢性非活动性肝炎(142例,29.1%),慢性活动性肝炎(165例,33.8%),伴有小叶下坏死的慢性肝炎(33例,6.8%),肝硬化前期(51例,10.5%),肝硬化(27例,5.5%)。还按性别、年龄等讨论了组织学特征与临床特征之间的关系。在41例随访病例中,就导致肝硬化的病因,讨论了组织学类型、乙肝表面抗原的存在情况或酒精因素的显著意义。

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