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目的 提出慢性和重型肝炎临床诊断标准和分型意见。方法 参照病毒性肝炎防治方案 ,对 895例重型肝炎、慢性肝炎和肝炎后肝硬化临床和病理对照结果进行综合研究。结果 ①慢性肝炎临床仍可分为轻、中、重三型 ,但其PTA值相应改为正常～ 71、70～ 61、60～ 5 1;A G值改为正常、1 5～ 1 3、1 2～ 1 0 ;ALT、BIL、γ球蛋白值可以保持不变 ;白蛋白值可以从慢性肝炎临床分型的参考指标中删除。②急性重型肝炎可分为早期 (水肿变性为主型 )、晚期 (坏死为主型 ) ;亚急性重型可分为腹水型、昏迷型和混合型。针对既无昏迷又无腹水 ,PTA在 60 %、5 0 %左右者可添加前期型。③亚急性和慢性重型仍可同时分为早、中、晚三期。④将亚急性重型的病程期限延长至半年。⑤慢性重型肝炎可分为Ⅰ (典型慢性肝炎型 )、Ⅱ (肝硬化型 )、Ⅲ型 (慢性肝炎或携带者基础上急性肝衰竭型 )。结论 原 1995年的方案基本可行
Objective To propose the clinical diagnostic criteria and classification of chronic and severe hepatitis. Methods A total of 895 cases of severe hepatitis, chronic hepatitis and posthepatitic cirrhosis patients were enrolled in the study according to the control scheme of viral hepatitis. Results ① The clinical features of chronic hepatitis were still divided into mild, moderate and severe types, but their PTA values were changed to normal ~ 71,70 ~ 61,60 ~ 51; AG values were changed to normal, 15 ~ 13,1 2 ~ 1 0; ALT, BIL, γ globulin values can be maintained; albumin values can be removed from the reference markers of clinical classification of chronic hepatitis. ② acute severe hepatitis can be divided into early (edema degeneration mainly), late (necrosis-based); subacute severe can be divided into ascites, coma and mixed. For neither coma nor ascites, PTA 60%, 50% or so may be added to the pre-type. ③ subacute and chronic severe can still be divided into early, middle and late three. ④ sub-acute heavy duration of the disease extended to six months. ⑤ chronic severe hepatitis can be divided into Ⅰ (typical chronic hepatitis type), Ⅱ (cirrhosis), Ⅲ (chronic hepatitis or carriers based on acute liver failure type). Conclusion The original 1995 plan is basically feasible