ウイルス肝炎より肝硬変への移行 ―腹腔鏡と臨床観察による進展要因―

Some prognostic parameters influencing the progress of hepatitis to liver cirrhosis were investigated and evaluated retrospectively. The hepatitis patients, who had twice or more been performed peritoneoscopy at First Department of Internal Medicine, Okayama University Medical School, between 1958 and 1976, were selected. Fifteen patients out of 102 with smooth liver surface observed at the first peritoneoscopic examination progressed to liver cirrhosis. Higher progress rate of 37.9% (11cases of 29) was observed in HBsAg positive group, whereas a lower rate of 10.5% (4cases of 38) was observed in HBsAg and HBsAb negative group. No progress was observed in the 35cases of HBsAb positive group. Liver cirrhosis was highly advanced among youth in the HBsAg positive group, and highly advanced with age in both the HBsAg and HBsAb negative group. The former required less period of time to develop liver cirrhosis as compared to the latter. Higher rate of advancement to liver cirrhosis was observed in both the patient without hepatomegaly at the onset of disease and one with high TTT values and low blood plasma disappearance rate of ICG. The rate of advancement of hepatitis to liver cirrhosis was not correlated with presence of jaundice or splenomegaly, and changes of serum bilirubin, GPT, ZTT, and gamma-globulin values.