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目的探讨小儿乙、丙型肝炎临床与病理的关系。方法①对我院小儿肝病科1983-2004年1694例小儿采用1秒钟肝穿法进行肝活检。②病毒性肝炎采用国内最新分型标准,对肝脏炎症活动程度分级(G0-4级),对纤维化分期(S0-4期)。结果①病毒性肝炎1505例,占88.8%,其中首位是乙型肝炎1230例(占81.7%),其次为丙型肝炎154例(占10.2%)。②小儿乙型肝炎中,261例(89.4%,261/292)慢性乙型肝炎患儿被误诊为“健康携带者”;小儿丙型肝炎中,19例(19/154,12.3%)慢性丙型肝炎患儿被误诊为“健康携带者”。结论目前我国小儿肝病病因中乙型肝炎占首位。当前在国内肝病诊治方案中,仅依据肝功能判断肝脏病变的存在和程度做为抗病毒治疗指征和判断预后,存在一定缺陷,须要进一步修正。
Objective To investigate the relationship between clinical and pathological features of children with hepatitis B and C hepatitis. Methods ① pediatric liver disease in our hospital from 1983 to 2004, 1694 cases of children with liver biopsy by 1 second method. ② Viral hepatitis using the latest national classification criteria, grade of liver inflammation (G0-4 level), fibrosis (S0-4 stage). Results ① There were 1,505 cases of viral hepatitis, accounting for 88.8%. Among them, the first place was hepatitis B (1230 cases) (81.7%), followed by hepatitis C (154 cases) (10.2%). ② In pediatric hepatitis B, 261 (89.4%, 261/292) children with chronic hepatitis B were misdiagnosed as “healthy carriers”; in pediatric hepatitis C, 19 (19/154, 12.3%) chronic hepatitis C Children with hepatitis are misdiagnosed as “healthy carriers.” Conclusion At present, hepatitis B is the most important cause of pediatric liver disease in our country. Currently in the domestic diagnosis and treatment of liver disease program, only based on liver function to determine the presence and extent of liver disease as anti-viral treatment indications and prognosis, there are some shortcomings, the need for further amendments.