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.