病毒性肝炎肝组织病理活动性量化诊断标准探讨.docVIP

???? 病毒性肝炎肝组织病理活动性量化诊断标准探讨 ???? ???? 摘要：目的　通过量化手段确定各种基本病理变化在肝病诊 断中的价值，建立肝组织病理活动性量化诊断标准及坐标系。方法　选取 基本病理变化各11项分别作为诊断的急性和慢性指标，每项指标均赋于一定分值和级差，各 单项分值叠加分别得出肝组织急性活动性指数和肝组织慢性活动性指数，以慢性分值为横坐 标，急性分值为纵坐标建立坐标系。对1008例各类肝病进行评价并与常规读片及Knodell?H AI对比观察。结果行方差分析及q检验。结果　急重肝、亚重肝、慢重 肝的HAAI分值分别为43.56±9.08，51.63±12.13和65.45±17.51(P0.01)；轻、中、 重度慢性肝炎的HCAI分别为13.25±6.90，40.29±10.99和50.02±9.78(P0.01)。静止 性肝硬变与活动性肝硬变的HAAI分别为31.17±9.07和64.96±16.60(P0.01)。随机抽 取的120例肝标本，诊断总符合率达66.66%～100%。结论　该标准应用方便 ，诊断准确，重复性强，具有良好的区别性。关键词：病毒性肝炎；肝穿刺活检；病理诊断；量化指数中分类号：R512.6；R361.2　　　文献标识码：A　　 　文章编号：1001-8174(2000)05-0268-03 Evaluation of Numerical Scoring Parameters for Assessing HistologicalActivity in Viral Hepatitis WEI Lian-jun　GAO Hong-bo　JIAO Fu-lan（The People?s Hospital of Dangshan County,Dangshan 235300,China）DUAN Guang-qiu（The H ealth School of Dangshan County,Dangshan 235300,China） Abstract:Objective　To evaluate the diagnostic values of characteristic pathologic changes in the liver biopsy specimens,and to develop a numerical scoring diagnostic standard and coordinates system.Method　 11 categories of charateristic pathologic lesions that often appeared in acute hepatitis,as so 11 categories in chronic hepatitis were chosen.Each of th em was graded to 3 scales,then the essential score and scale score were set up.A dding up to all the numerical scores of individual components,formed the total s cores of histological chronic activity index(HCAI) and histological acute activi ty index(HAAI),using HCAI as transverse coordinates and HAAI as vertical coordin ates,coordinates system was set up.1008 patients with various liver diseases wer e studied,and compared with conventional readings and Knodell?HAI.F analysi s and q test were carried on.Results　The HAAI of acute,suba cute,and chronic severe hepatitis was 43.56±9.08，51.63±12.13，and 65.45±17.5 1 respectively.There was significant difference between each other(P0.01).H CAI of them was 13.25±6.90,40.29±10.99,and 50.02±9.78 respectively.There was also signific