Journal of Okayama Medical Association
Published by Okayama Medical Association

Full-text articles are available 3 years after publication.

Virus性肝炎の慢性化に関する臨床的並びに病理組織学的研究 第1編 退院患者の遠隔成績に関する検討

清藤 一郎 岡山大学医学部第一内科教室
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Follow up studies were made on the discharged 360 cases of viral hepatitis whom needle liver biopsy had been performed during the past 6 years. (1). According to the histological picture, the cases were divided into the following groups: Acute hepatitis: Chronic hepatitis: Parenchymatous type Progressive chronic hepatitis Non-Progressive chronic hepatitis Pre-cirrhotic type Post-hepatitic cirrhosis: Cholangiolitic hepatitis: This division proved significant for prognostic study as well.(2). The mortality rate of liver cirrhosis was 11.2%. (3). Out of 219 persons who answered their clinical course after discharge, 4 was attacked by cholecystopathy; 4, by appendicitis; 3, by rheumatic arthoritis; and 4, by hemorrhoid, the total being 12.3%. (4). 3.2% of all suffered from jaundice after discharge while onefourth were susceptible to common cold and another one-fourth had gingical bleeding. (5). Only 10.9% of all were free from subjective symptom; 77.0% had fatigability; 44.7 % complained general fatigue and such disorders as headache, distended feeling of epigastrium and right hypochondriral pain followed in that order. Those symptoms were most predominant among the cases of non-progressive chronic hepatitis but were rarely found among those of acute hepatitis and parenchymatous type of chronic hepatitis. There was a tendency that the symptom disappeared gradually with recovery among acute cases while it lasted long among chronic ones. (6). Those who were subjected to precise examination showed the following results: Acute cases: 15.4% remained normal in 1-7 years after discharge. 41.6% complained subjective symptoms only. 34.8% developed into chronic. Chronic cases: 9.2% remained normal. 35.5% complained subjective symptoms only. 44.7% suffered from persistent impairment of liver function tests. Post hepatitic cirrhosis: 3.0% remained normal. 7.4% complained subjective symptoms only. 84.7% suffered from the persistent impairment of liver function tests. (7). 59.6% suffered from hepatomegaly while 12.9%, from splenomegaly. (8). Those who were examined consecutively showed a strong tendency to aggravation in each type. (9). The Stages of aggravation were clarified by the histological findings of the liver of those who were hospitalized for the second time, especially the aggravation to Laennec's cirrhosis.