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发表于 2002-5-30 17:04
| 研究早发现, 患有肝炎, 如: 丙肝的病人在声纳图像上都显示伴有 "perihepatic 淋巴结" 增大现象. 它和肝脏组织, 病毒血症有密切关系, 而这两样对病人肝脏的损害, 病情都有关系. 那么 "perihepatic 淋巴结" 与乙肝病人呢?
韩国医生去年的一份研究显示, 几乎全部慢性乙肝病人都显示有 "perihepatic 淋巴结" 存在, 和 AST, ALT GGT 等有关系, 但是和纤维化分级, 病毒血无关;
结论是: "perihepatic 淋巴结" 的出现对于组织, 生化性炎症是好现象, 但是对病毒血关系.
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APRIL 2001 VIRAL HEPATITIS B-Clinical Significance of Enlarged Perihepatic Lymph Nodes in Chronic Hepatitis B
Moon Seok Choi, ; Joon Hyeok Lee,.; Kwang Cheol Koh,.; Seung Woon Paik,.; Poong-Lyul Rhee,.; Jae Jun Kim, ; Jong Chul Rhee,; Kyoo Wan Choi, ; Seung Hoon Kim,.
From the Division of Gastroenterology, Department of Medicine (M.S.C., J.H.L., K.C.K., S.W.P., P-L.R., J.J.K., J.C.R., K.W.C.), and the Department of Diagnostic Radiology (S.H.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Goals: to evaluate the clinical significance of enlarged perihepatic lymph nodes in patients with chronic hepatitis B.
Background: enlargement of perihepatic lymph node is a common finding during ultrasonography in patients with chronic hepatitis. Its relation with liver histology and viremia was reported in chronic hepatitis C, but little has been known about its clinical significance in chronic hepatitis B.
Study: we evaluated the clinical significance of perihepatic lymphadenopathy in chronic hepatitis B. In 50 patients with biopsy-proven chronic hepatitis B and 15 healthy controls, the perihepatic lymph node volume was evaluated by ultrasonography and its possible correlation with biochemical tests, hepatitis activity index, and hepatitis B viremia was investigated.
Results: perihepatic lymph node was detected in 48 of 50 patients with chronic hepatitis B (volume = 3.4 ± 2.4 mL) and in two of 15 controls (0.4 mL and 0.6 mL). In chronic hepatitis B, lymph node volume showed a significant correlation with serum aspartate transaminase (r = 0.66), alanine transaminase (r = 0.63), gamma-glutamyl-transpeptidase (r = 0.53), histologic activity index (r = 0.59), and necroinflammatory score (r = 0.59; p < 0.05 for all), but not with fibrosis score and serum hepatitis B viremia.
Conclusions: enlarged perihepatic lymph nodes in chronic hepatitis B can be a good indicator for histologic and biochemical inflammatory activity of the liver, but not for viremia. (,J. Clin. Gastroent.;32:329-332, 2001)
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