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非甲非乙型输血后肝炎的长期病程。

The long-term course of non-A, non-B post-transfusion hepatitis.

作者信息

Koretz R L, Stone O, Gitnick G L

出版信息

Gastroenterology. 1980 Nov;79(5 Pt 1):893-8.

PMID:6774906
Abstract

Patients with non-A, non-B post-transfusion hepatitis were followed from the onset of their disease until their blood tests normalized, until they died, or until the present time. Of 66 patients, 30 had a spontaneous resolution of their biochemical disease. Ten patients died or were begun on immunosuppressive therapy with transaminases still abnormal. The remaining 26 patients had abnormal transaminase levels when last seen. By actuarial analysis, only 54% of hepatitis patients are predicted to develop s spontaneous biochemical remission within 3 yr. No further resolutions have occurred after that time, Icteric and anicteric acute disease may be equally likely to progress to chronic disease. Initial and follow-up liver biopsy specimens have revealed both chronic persistent and chronic active hepatitis. Two patients showed histologic evidence of cirrhosis, and a third developed a hepatic coagulopathy and sphenomegaly. No other patient to date, however, has veveloped overt evidence of hepatocellular failure or portal hypertension. Thus, non-A, non-B post-transfusion hepatitis frequently results in biochemical evidence of chronic liver disease, and in a few patients cirrhosis may develop slowly and in a clinically inapparent fashion.

摘要

对非甲非乙型输血后肝炎患者从发病开始进行随访,直至其血液检查恢复正常、死亡或直至目前。66例患者中,30例生化指标异常自发缓解。10例患者死亡或在转氨酶仍异常时开始接受免疫抑制治疗。其余26例患者最后一次检查时转氨酶水平仍异常。通过精算分析,预计只有54%的肝炎患者在3年内会出现生化指标的自发缓解。此后未再出现缓解情况。黄疸型和无黄疸型急性疾病进展为慢性疾病的可能性相当。初次及随访肝脏活检标本显示既有慢性持续性肝炎,也有慢性活动性肝炎。2例患者有肝硬化的组织学证据,第3例出现肝性凝血障碍和脾肿大。然而,迄今为止,没有其他患者出现明显的肝细胞衰竭或门静脉高压证据。因此,非甲非乙型输血后肝炎常导致慢性肝病的生化证据,少数患者可能会缓慢发展为肝硬化,且临床上不易察觉。

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