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[慢性B型和C型病毒性肝炎的长期预后]

[Long-term prognosis of chronic B and C viral hepatitis].

作者信息

Ohlen J, Liegl J M, Selmair H

机构信息

Klinik Wartenberg, Wartenberg, Obb.

出版信息

Leber Magen Darm. 1995 Sep;25(5):205-10.

PMID:7500807
Abstract

146 patients (62 female, 84 male) with chronic hepatitis B and 80 patients (34 female, 46 male) with chronic hepatitis C were regularly examined in 1 to 2 year intervals with an average follow-up period of 12 years (mean). Each time patients were evaluated by physical examination, routine laboratory data, immunological and serological testing, ultrasonography, and laparoscopy and/or percutaneous liver biopsy. No patient of the study underwent immunosuppressive or antiviral treatment at any time.-The average time data in years are given as the median value (mean). Chronic hepatitis B: Histologic diagnoses and their long-term prognosis: Chronic persistent hepatitis (CPH) on first biopsy: 10% of cases complete recovery after 15 years, 70% progression to chronic active hepatitis (CAH) after 5 years; CAH: 30% advanced remission/complete recovery 8 years after the first diagnosis of CAH, 40% progression to liver cirrhosis after 5 years; liver cirrhosis: 50% advanced remission/recovery 4 years after the first diagnosis of cirrhosis, 5% developed a hepatocellular carcinoma (HCC) 11 years after the first diagnosis of cirrhosis. Natural history: In the 11 years following initial diagnosis of HBV-infection spontaneous recovery was observed in 49% of cases. In 3% of the patients the disease eventually caused death (1 x hemorrhage of oesophageal varices, 3x HCC after 14 to 20 years). Chronic hepatitis C: All patients were anti-HCV- and HCV-RNA-positive.-There was no spontaneous elimination of virus in any patient (maximal follow-up 27 years).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

146例慢性乙型肝炎患者(62例女性,84例男性)和80例慢性丙型肝炎患者(34例女性,46例男性)每隔1至2年定期接受检查,平均随访期为12年(均值)。每次对患者进行体格检查、常规实验室数据、免疫和血清学检测、超声检查以及腹腔镜检查和/或经皮肝活检评估。该研究中没有患者在任何时候接受过免疫抑制或抗病毒治疗。-以中位数(均值)给出以年为单位的平均时间数据。慢性乙型肝炎:组织学诊断及其长期预后:首次活检时为慢性持续性肝炎(CPH):15年后10%的病例完全恢复,5年后70%进展为慢性活动性肝炎(CAH);CAH:首次诊断CAH后8年30%病情显著缓解/完全恢复,5年后40%进展为肝硬化;肝硬化:首次诊断肝硬化后4年50%病情显著缓解/恢复,首次诊断肝硬化后11年5%发生肝细胞癌(HCC)。自然史:在初次诊断HBV感染后的11年里,49%的病例观察到自发恢复。3%的患者最终因病死亡(1例食管静脉曲张出血,3例在14至20年后发生HCC)。慢性丙型肝炎:所有患者抗-HCV和HCV-RNA均为阳性。-没有患者出现病毒自发清除(最长随访27年)。(摘要截断于250字)

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