Meyer K H
Z Gesamte Inn Med. 1977 Jan 1;32(1):10-6.
After a short historical retrospect and a comment on the nomenclature and on the notion of chronic hepatitis and liver cirrhosis the diagnostic criteria and immunopathological peculiarities of virus-induced HBsAg-positive, non-virus-induced autoimmune, drug-induced and finally cryptogenic chronically progressing liver diseases are discussed. Immunoserology and immunohistology are nowadays to be regarded as the most important enrichments in the diagnostic spectre for the differentiation of chronic inflammatory liver diseases. In order to complete the diagnostic programme and to understand the pathogenesis of cryptogenic chronic hepatitides as soon as possible an establishment of the hepatitis-A- and C-serology is necessary. Apart from a further analysis of the group of the non-B-hepatitides the diagnostic use of other markers of virus hepatitides will be able to adopt a definite attitude to the unclarified question of virus-induced autoimmunopathies in liver diseases. The primary biliary cirrhosis with the morphologic findings of a chronically destructing, non-purulent cholangitis is an immunologically conditioned liver diseases of unknown etiology, which in contrast to the autoimmune chronic active hepatitides and liver cirrhoses is not to be influenced in the course by therapeutic measures.
在对慢性肝炎和肝硬化的命名及概念进行简短的历史回顾和评论之后,讨论了病毒诱导的HBsAg阳性、非病毒诱导的自身免疫性、药物诱导以及最终原因不明的慢性进行性肝病的诊断标准和免疫病理特征。如今,免疫血清学和免疫组织学被视为慢性炎症性肝病诊断领域最重要的补充手段。为了完善诊断方案并尽快了解原因不明的慢性肝炎的发病机制,有必要进行甲型和丙型肝炎血清学检测。除了对非乙型肝炎组进行进一步分析外,病毒肝炎其他标志物的诊断应用将有助于明确肝病中病毒诱导的自身免疫性疾病这一未解决的问题。原发性胆汁性肝硬化具有慢性破坏性、非化脓性胆管炎的形态学表现,是一种病因不明的免疫性肝病,与自身免疫性慢性活动性肝炎和肝硬化不同,其病程不受治疗措施的影响。