小兒急性病毒性肝炎之追跡研究

A Follow-up Study on Acute Viral Hepatitis in Children

吳康文(K. W. Wu) ； 蕭柳青(L. C. Shiao) ； 施仲舜(J. S. Shih)

《Acta Paediatrica Sinica》 16卷2期 (1975/06) Pp. 62-68

摘要

對7例（年齡1歲5個月到9歲1個月）經肝活體組織檢查及肝功能檢查證明為急性病毒性肝炎的患兒（黃疸性3名，無黃疸性4名）追跡觀察三年，其間反覆地做肝功能、理學以及肝活體組織檢查。組織檢查診斷則以1968年歐洲肝臟研究會所訂的「慢性肝炎之分類」為依據。結果發現一年後有5例呈慢性持續性肝炎，其中2例2年後仍呈慢性持續性肝炎組織像，但3年後全例恢復正常組織像，則小兒急性病毒性肝炎，過急性期，雖然臨床症狀及肝功能恢復正常後，大部分患兒仍有一段時日（1至3年）變為慢性持續性肝炎，一般認為慢性持續性肝炎較好，不像慢性侵略性肝炎較容易變成肝硬變。本研究結果不單反映小兒急性病毒性肝炎預後較好的事實，亦證實急性病毒性肝炎仍為慢性肝炎病因之一。

並列摘要

Seven cases of acute viral hepatitis proved by liver function tests and needle biopsy were followed up for 3 years' duration. Physical examination, liver function tests and needle biopsy were carried out every year.
Histological diagnosis of the liver biopsy depends upon the classification of chronic hepatitis established by the European Association for the Study of Liver in 1968.
Five cases showed the picture of chronic persistent hepatitis after one year, and at least two of them still showed the same change even one more year later. Three years after the onset. of the acute illness, histological picture of the liver biopsy became normal in all cases. Thus, it is common that chronic persistent hepatitis may follow after acute viral hepatitis in. children and may persist for a couple of years even if there is no abnormalities in clinical manifestation and liver function tests.
It is believed that the prognosis of chronic persistent hepatitis is generally good, whereas many ‘cases of chronic aggressive hepatitis result in, cirrhosis.
This follow-up study not only suggests that the prognosis of acute viral hepatitis in children is gener1ly good, but also provides the evidence that acute viral hepatitis can be one of the, causes of chronic persistent hepatitis.