SURVIVAL AND HISTOLOGICAL RESOLUTION OF FIBROSIS IN PATIENTS WITH AUTOIMMUNE CHRONIC ACTIVE HEPATITIS
SURVIVAL AND HISTOLOGICAL RESOLUTION OF FIBROSIS IN PATIENTS WITH AUTOIMMUNE CHRONIC ACTIVE HEPATITIS
复制标题
DOI：
10.1016/s0168-8278(05)80005-4
复制
发表时间：
1993-04-01
影响因子：
25.7
通讯作者：
WEILAND, O
中科院分区：
文献类型：
--
作者：
SCHVARCZ, R;GLAUMANN, H;WEILAND, O
回顾性评估了33例自身免疫性慢性活动性肝炎患者的生存率和长期临床及组织学结局。33例患者中有30例符合马约诊所的治疗标准，16例（48%）出现提示结节性纤维化和/或肝硬化的组织学体征。通过寿命表分析发现，总的10年生存率为90%。这与匹配的对照组（92%）没有显著差异。配对肝活检显示，28例患者中有16例（57%）改善了其纤维化/肝硬化类别，而在中位49个月后进行的随访活检中无进展。此外，肝活检显示14例初始结节性纤维化/肝硬化患者中有9例改善，并消退了结节。当应用半定量评分系统时，中位纤维化评分显著改善。干预纤维化进展的一个关键因素似乎是免疫抑制治疗导致的炎症活动减少。我们的结论是，纤维化可能会解决自身免疫性慢性活动性肝炎后，长期和有效的治疗，这是在病程的早期开始。
Survival and long-term clinical and histological outcome were assessed retrospectively in 33 patients treated for autoimmune chronic active hepatitis. The Mayo Clinic treatment criteria were met by 30 of 33 patients and histological signs indicating nodular fibrosis and/or cirrhosis were present in 16 of 33 (48%). An overall 10-year survival rate of 90% was found by life-table analysis. This was not significantly different from matched controls (92%). Paired liver biopsies revealed that 16 of 28 (57%) patients improved their fibrosis/cirrhosis category whereas none progressed in a follow-up biopsy performed a median of 49 months later. Furthermore, liver biopsy showed improvement in 9 of 14 patients with initial nodular fibrosis/cirrhosis and resolution of nodulation. When a semi-quantitative scoring system was applied, the median fibrosis score improved significantly. A key factor intervening in the progression of fibrosis seemed to be the reduction of inflammatory activity as a result of immunosuppressive treatment. We conclude that fibrosis may be resolved in autoimmune chronic active hepatitis following protracted and effective treatment which is initiated early in the course of the disease.