Weissberg J I, Andres L L, Smith C I, Weick S, Nichols J E, Garcia G, Robinson W S, Merigan T C, Gregory P B
Ann Intern Med. 1984 Nov;101(5):613-6. doi: 10.7326/0003-4819-101-5-613.
Survival data from 379 patients with chronic hepatitis B were analyzed to determine life expectancy for the patient from the time of first contact. One hundred twenty-one patients had chronic persistent hepatitis, 128 had chronic active hepatitis, and 130 had chronic active hepatitis with cirrhosis. The frequency of symptoms (p less than 0.001), stigmata of chronic liver disease (p less than 0.001), and liver function test abnormalities (p less than 0.001) increased as the histologic features worsened, whereas the percentage of patients with circulating hepatitis B DNA polymerase declined (p less than 0.001). Women were uncommon in our series and had less severe disease than men (p less than 0.02). Fifty-one patients had died by the time of this analysis. The estimated 5-year survival rates were 97% for patients with chronic persistent hepatitis, 86% for those with chronic active hepatitis, and 55% for those with chronic active hepatitis with cirrhosis. The usual cause of death was liver failure and its sequelae. A multivariate analysis found age of 40 years or more, total bilirubin level of 1.5 mg/dL or more, ascites, and spider nevi to be factors that identified patients at a higher risk of death. The prognosis for patients with chronic hepatitis B is similar to that for patients with chronic hepatitis of other causes.
对379例慢性乙型肝炎患者的生存数据进行分析，以确定患者从首次就诊时起的预期寿命。121例患者为慢性持续性肝炎，128例为慢性活动性肝炎，130例为慢性活动性肝炎伴肝硬化。随着组织学特征恶化，症状出现频率（p<0.001）、慢性肝病体征（p<0.001）和肝功能检查异常（p<0.001）增加，而循环中乙肝DNA聚合酶阳性患者的百分比下降（p<0.001）。在我们的系列研究中女性较少见，且病情比男性轻（p<0.02）。在本次分析时已有51例患者死亡。慢性持续性肝炎患者的估计5年生存率为97%，慢性活动性肝炎患者为86%，慢性活动性肝炎伴肝硬化患者为55%。常见的死亡原因是肝衰竭及其后遗症。多因素分析发现，年龄40岁及以上、总胆红素水平1.5mg/dL及以上、腹水和蜘蛛痣是识别死亡风险较高患者的因素。慢性乙型肝炎患者的预后与其他原因引起的慢性肝炎患者相似。
