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Chronic Hepatitis

1. Á¤ÀÇ

¿©·¯ °¡Áö ¿øÀο¡ ÀÇÇØ hepatic inflammation & necrosis°¡ 6°³¿ù ÀÌ»ó ÁøÇàµÉ ¶§

¸¸¼º°£¿°À̶ó ÇÑ´Ù.

* 3°¡Áö category

¨ç Chronic viral hepatitis

¨è Drug-induced chronic hepatitis

¨é Autoimmune hepatitis

±×¿Ü hereditary/metabolic disorders(Wilson's diseaseµî), Alcoholic liver injury

2. ºÐ·ù

°ú°Å milder form - CPH, CLH

more severe form - CAH

óÀ½ Á¤ÀǵǾúÀ» ¶§ ÀÌ·± Ç¥ÇöÀÌ ¿¹Èĸ¦ ³ªÅ¸³»´Â °ÍÀ¸·Î »ý°¢ÇßÀ¸³ª ÃÖ±Ù ÀÌ·¯ÇÑ »ý°¢ÀÌ

¹Ù²î¾ú´Ù. 20³âÀÌ»ó ÀÌ·± ¹æ½ÄÀÇ Ç¥ÇöÀÌ Àû¿ëµÇ¾úÀ¸³ª ¿øÀÎ, ÀÚ¿¬°æ°ú, º´ÀÎ, Ç÷ûÇÐÀû Ư¡,

Ä¡·á¿¡ ´ëÇÑ º¸´Ù À¯¿ëÇÑ ¸¹Àº Á¤º¸°¡ »ý°å´Ù. ±×·¯¹Ç·Î ¸¸¼º°£¿°¿¡ °üÇÑ ¹üÁÖ´Â ÀÏÂ÷Àû

À¸·Î Á¶Á÷º´¸®ÇÐÀû Ư¡¿¡ ±âÃʸ¦ µÎ´ø °ÍÀÌ ÀÓ»óÀû, Ç÷ûÇÐÀû, Á¶Á÷ÇÐÀû º¯¼öÀÇ Á¶ÇÕ¿¡

±âÃʸ¦ µÎ´Â ºÐ·ù·Î ´ëüµÇ¾ú´Ù.

* »õ·Î¿î ºÐ·ù¹ý(CGS)

¨ç Cause

¨è Grade : histologic activity¿¡ µû¶ó

¨é Stage : progressionÁ¤µµ¿¡ µû¶ó

»ó±â 3°¡Áö ±âÁØ¿¡ ±âÃÊÇÑ´Ù. clinical feature or histologic feature¾î´À ´Üµ¶À¸·Î ºÐ·ùÇϱ⿣

ÃæºÐÄ¡ ¾Ê´Ù.

(1) ¿øÀο¡ µû¸¥ ºÐ·ù

¨ç Chronic viral hepatitis(B, B+D, C, other)

¨è Autoimmune hepatitis, type 1,2,3

¨é Drug-induced hepatitis

¨ê Cryptogenic chronic hepatitis

(2) Grade¿¡ µû¸¥ ºÐ·ù - necroinflammatory activityÁ¤µµ¸¦ Æò°¡

¨ç periportal necrosis - piecemeal necrosis, bridging necrosisÆ÷ÇÔ

¨è intralobular necrosis

¨é portal inflammation

(3) Stage¿¡ µû¸¥ ºÐ·ù - fibrosisÁ¤µµ¿¡ µû¶ó

0 - no fibrosis

1 - mild fibrosis

2 - moderate fibrosis

3 - severe fibrosis

4 - cirrhosis

* Knodell-Ishak scoring system(Histologic activity index, HAI) Tab 297-2

grade, stage¿¡ µû¶ó 0-22Á¡±îÁö

(4) °ú°Å Á¶Á÷ÇÐÀû ºÐ·ù¹ý°ú »õ·Î¿î ºÐ·ù¹ýÀÇ ºñ±³ Tab 297-3

CAHÀÇ 20-50%°¡ cirrhosis¸¦ µ¿¹ÝÇϰí ÀÖ´Ù.