Sekiya C, Mima S, Yazaki Y, Takasugi Y, Namiki M
Hokkaido Igaku Zasshi. 1978 Sep;53(5):303-11.
47 cases of viral hepatitis with HBs antigenemia, who were diagnosed by peritoneoscopy and biopsy, were studied. 41 cases were males, and 6 cases were females. The onset ages were mostly in 25--29 years old. The histories of blood transfusion were found in only 4.3%. On the other hand, the families clustered with HBs antigen were found in 68%. Recidivums were often seen (76%), and yet the intervals between recidivum were short (the neighborhood of 8 months). The transaminases at the recidivums were not so high (200 units or thereabout). 20 cases whom biopsies were performed more than twice, were studied histologically. 14 cases were prognessive. 5 were stationary. 1 was improved. In all of progressive cases, sublobular hepatic necrosis was seen. But in other cases, sublobular necrosis was not seen. After this sublobular necrosis, various distortion of the lobule architecture was appeared, and some of them progressed to liver cirrhosis. As to GOT and GPT, GPT was dominant before sublobular neerosis, but GOT was liable to be dominant after sublobular necrosis. Peritoneoscopically, peculiar red spots were found on liver surfaces at the time of sublobular necrosis.
对47例经腹腔镜检查和活检确诊为乙型肝炎表面抗原血症的病毒性肝炎患者进行了研究。其中男性41例，女性6例。发病年龄多在25至29岁。仅4.3%的患者有输血史。另一方面，68%的患者有乙型肝炎表面抗原家族聚集现象。复发情况常见（76%），但复发间隔时间短（约8个月）。复发时转氨酶不太高（约200单位）。对20例进行了两次以上活检的患者进行了组织学研究。14例病情进展，5例稳定，1例好转。在所有病情进展的病例中，均可见小叶下肝坏死。但在其他病例中，未见小叶下坏死。小叶下坏死出现后，小叶结构出现各种变形，其中一些发展为肝硬化。至于谷草转氨酶（GOT）和谷丙转氨酶（GPT），在小叶下坏死前GPT占主导，但在小叶下坏死后GOT易占主导。在腹腔镜检查中，小叶下坏死时肝脏表面发现特殊的红点。
