Takahashi M, Yamada G, Miyamoto R, Doi T, Endo H, Tsuji T
First Department of Internal Medicine, Okayama University Medical School, Japan.
Am J Gastroenterol. 1993 Feb;88(2):240-3.
We studied 333 chronic hepatitis C patients to evaluate the natural course of this disease. Among 57 patients undergoing serial biopsies, 20 had chronic persistent hepatitis (CPH) at the first biopsy, and 10 of them progressed to chronic active hepatitis (CAH) or liver cirrhosis (LC) after 11 yr. Sixteen patients had CAH 2A, and this progressed to CAH 2B or LC in 10 cases over 9 yr. Among the 21 patients with CAH 2B, progression to LC was noted in 15 after 7 yr. Among the 100 patients observed for over 5 yr, the normalization of liver function for at least 3 yr was seen in only four patients. In two of these four patients, serum HCV-RNA was tested serially. Despite the sustained normalization of alanine aminotransferase levels, HCV-RNA continued to be detectable in one patient. We conclude that many patients with chronic hepatitis C eventually show progression of their disease after a long and symptomless course.
我们研究了333例慢性丙型肝炎患者，以评估这种疾病的自然病程。在57例接受系列活检的患者中，20例在首次活检时患有慢性持续性肝炎（CPH），其中10例在11年后进展为慢性活动性肝炎（CAH）或肝硬化（LC）。16例患者患有2A期CAH，其中10例在9年中进展为2B期CAH或LC。在21例2B期CAH患者中，15例在7年后进展为LC。在100例观察超过5年的患者中，只有4例患者肝功能至少3年保持正常。在这4例患者中的2例中，连续检测了血清HCV-RNA。尽管丙氨酸转氨酶水平持续正常，但1例患者仍可检测到HCV-RNA。我们得出结论，许多慢性丙型肝炎患者在经历漫长且无症状的病程后最终会出现疾病进展。
