Demina E A
Ter Arkh. 1984;56(8):135-7.
To identify a group of patients who are likely to have specific liver damage (a risk group), 88 patients with lymphogranulomatosis were examined. The examination program included clinical studies, liver scanning, peripheral blood analysis, blood serum biochemistry, study of the bone marrow, liver biopsy in all the patients. Eleven patients manifested specific liver damage. In all the patients with liver lymphogranulomas, the disease ran an unfavourable course; they frequently demonstrated the symptoms of intoxication enlargement of the liver size, focal changes on the scanogram and concurrent damage to the bone marrow. According to the biochemical tests, high activity (over 200 U/l) of alkaline phosphatase was recorded exclusively in patients with the lymphogranulomatosis-induced liver damage. Nevertheless, none of the above-enumerated signs regarded separately cannot serve as criterion of the diagnosis of lymphogranulomatosis metastases to the liver. Analysis of the rate of association of individual clinical symptoms and laboratory findings demonstrated that the most informative were associations of high alkaline phosphatase activity and enlargement of the liver size, as well as association of thrombocytopenia and anemia. However, histological study of liver biopsies is the most reliable method of diagnosis of lymphogranulomatosis metastases to the liver, particularly in patients with clinical stages I-II, since in such patients with lymphogranulomatosis, specific liver damage runs an asymptomatic course.
为了确定一组可能患有特定肝损伤的患者（风险组），对88例淋巴肉芽肿病患者进行了检查。检查项目包括临床研究、肝脏扫描、外周血分析、血清生化检查、骨髓检查以及对所有患者进行肝脏活检。11例患者表现出特定的肝损伤。在所有患有肝淋巴肉芽肿的患者中，疾病进展不利；他们经常出现中毒症状、肝脏肿大、扫描图上的局灶性改变以及并发的骨髓损伤。根据生化检查，仅在患有淋巴肉芽肿病所致肝损伤的患者中记录到碱性磷酸酶高活性（超过200 U/l）。然而，上述任何一个单独的体征都不能作为诊断淋巴肉芽肿病肝转移的标准。对个体临床症状和实验室检查结果的关联率分析表明，最具信息量的是高碱性磷酸酶活性与肝脏肿大的关联，以及血小板减少症与贫血的关联。然而，肝脏活检的组织学研究是诊断淋巴肉芽肿病肝转移最可靠的方法，特别是对于临床I - II期的患者，因为在这些淋巴肉芽肿病患者中，特定的肝损伤呈无症状过程。
