【摘要】 目的判明慢性丙型肝炎的远期预后。方法对54例慢性丙型肝炎病人进行随防,其中男33例,女21例。进行问诊、体检及检测肝功能、肝纤维化指标、HCV RNA,B超等检查。结果54例中,1例因肝硬化并发反复消化道出血于1999年10月死亡,另外53例中,出现肝掌和蜘蛛痣13例,巩膜轻度黄染3例,肝功异常8例,肝纤维化指标增高17例,这17例中,有4例在近3年里因出现腹水而确诊为肝硬化。这4例中,出现肝硬化时间最早在病程的第5年,最长在第9年。血清HCV RNA阳性46例,阴性7例,在应用过干扰素的20例中,仍有17例HCV RNA阳性,而未用干扰素治疗的34例,亦有5例阴性,二者比较示HCV RNA阴转率没有明显区别。但出现肝掌和蜘蛛痣以及肝纤维化指标高者主要见于未用干扰素的病人,且4例肝硬化病人亦为非干扰素治疗者。结论慢性丙型肝炎病人,大部分肝功能仍不正常,86％以上的病人HCV RNA一直阳性,少部分病人已形成失代偿性肝硬化,若行肝穿刺活检。还可能有相当数量的病人不同程度存在肝硬化。因此,如何寻找出彻底清除丙型肝炎病毒、防止肝硬化发生的有效方法,仍是当前临床工作中的重要课题。更多还原

【Abstract】 Objective To investigate the long-term outcomes of patients with chronic hepatitis C. Methods 54 patients with chronic hepatitis C were followed up, including 33 men and 21 women. Our studies included other examinations such as liver function tests,liver fibrosis index tests,HCV - RNA and B type ultrasound.Results Of 54 patients, 1 died of cirrhosis and repeated hemorrhage of digestive tract in Oct, 1999. Of the other 53 patients, 13 had liver palms and ocular spider,3 cases had mild jaundice of comeaopaca, 38 patients’liver function were abnormal,17 patients’liver fibrosis index increased. Of these 17 patients, 3 were diagnosed as cirrhosis because of asctites.There were 4 cases with uncompensated cirrhosis.Of these 4 cases, the earliest time when patient appeared cirrhosis were during the 5th year of the course of disease and the latest were in the 9 th year. As for HCV RNA tests,46 were positive,7 negative. Of 20 patients who received therapy of interferon - α, 17 were positive for HCV RNA. In 34 patients who didn’ t receive therapy of inter-feron - α,5 were negative. It showed that there were no evident difference between HCV RNA negative rate.The patients with liver palms and spider and high liver fibrosis index were those who didn’t receive interferon - α. Conclusion Liver function tests in most patients with chronic hepatitis C were abnormal, and over 86% of patients, the HCV - RNA was positive and a small number of patients had formed uncompensated cirrhosis,perhaps more and more patients should have cirrhosis to a different extent.Therefore,how to find the effective methods to eliminate the virus of hepatitis C and prevent cirrhosis are still the important task of the clinical work.更多还原