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本文旨在对重症慢性活动性肝病(CALD)患者在应用皮质类固醇治疗期间及停药后,评价SGOT与γ球蛋白(GG)对肝细胞炎症反应的敏感性和特异性,并鉴定其可靠性。方法:69例符合临床、生化及组织学标准的重症CALD,按作者等所采用的三种治疗方案任选其一给予强的松治疗,6个月检查一次,停药后每6月随访一次至少1年。SGOT含量用分光光度法测定,GG含量用醋酸纤维素凝胶血清蛋白电泳法测定。在入院时及临床和实验室认为疗效满意预示可停药前,均作肝穿活检。然后以6周以上时间逐渐撤除强的松,在停药后的当天以及3个月内每3周由邮寄血清检查SGOT和GG。停药后6个月或以后需要时再作肝穿活检,或需要时加这个检查。组织学标准为:汇管区有慢性园形细胞浸润伴少量(或无)碎屑样坏死提示为非特异性(“慢性持续性”)肝炎;中等至重度碎屑样坏死伴有(或无)架桥形成或多小叶塌陷则符合CALD的病理诊断。将测
This article aims to evaluate the sensitivity and specificity of SGOT and gamma globulin (GG) on the hepatocellular inflammatory response in patients with severe chronic active liver disease (CALD) during corticosteroid treatment and after discontinuation, and to identify their reliability . Methods: Sixty-nine patients with severe CALD who met the clinical, biochemical and histological criteria were randomly assigned to receive either prednisone or trimethoprim (6 months). All patients were followed up every 6 months At least 1 year. SGOT content was determined spectrophotometrically, and GG content was determined using a cellulose acetate gel serum protein electrophoresis method. Liver biopsy was performed at hospital admission and in clinical and laboratory settings, indicating satisfactory efficacy, indicating discontinuation. Prednisone was then gradually withdrawn for more than 6 weeks, and SGOT and GG were checked by postal serum on the day after discontinuation and every 3 weeks for 3 months. Liver biopsy should be performed 6 months or more after discontinuation or when necessary. Histological criteria were: chronic park-cell infiltration associated with small (or no) debris-like necrosis in the portal area suggesting nonspecific (“chronic persistent”) hepatitis; moderate to severe debris-like necrosis with or without shelf Bridge formation or multilobulation is in line with CALD pathological diagnosis. Will measure