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对于慢性丙型肝炎(HCV)患者,肝组织学病理分期是治疗效果的一个重要预测因素。迄今为止,肝活检是确诊病理分期的必要手段,但费用及风险也随之增加。本文旨在寻求一种非创伤性但又能准确预测肝纤维化的实验室方法。 方法 回顾性评价211例在治疗前均作了肝活检的HCV患者。其中58例有酗酒史(每日饮酒含酒精量超过50g以上),无合并其他肝病。测定所有患者血清AST/ALT比值和血小板计数,检测结果选用最靠近肝活检日期的数值。肝脏细针穿刺活检标本单独由一个病理医师进行盲法评判积分并确定肝纤维化病理分期。所有活检组织大小适当,含有4个以上的汇管区。肝纤维化分期和炎症分级为无(0)、轻度(1)、中度(2)、重度(3)、肝硬化(4)。
For patients with chronic hepatitis C (HCV), histopathology of the liver is an important predictor of treatment outcome. To date, liver biopsy is a necessary tool to confirm the pathological stage, but costs and risks also increase. This article aims to seek a non-invasive but accurate prediction of liver fibrosis laboratory method. Methods A retrospective review of 211 patients with HCV who underwent liver biopsy before treatment was retrospectively reviewed. 58 cases of alcoholism (daily alcohol consumption more than 50g), without other liver disease. All patients were measured serum AST / ALT ratio and platelet count, the test results using the closest date of liver biopsy. Liver fine needle aspiration biopsy specimens were scored blindly by a pathologist and pathological stage of liver fibrosis was determined. All biopsies are appropriately sized and contain more than 4 access tubes. Liver fibrosis staging and inflammation were graded as no (0), mild (1), moderate (2), severe (3), cirrhosis (4).