小牧 斎, 三原 謙郎, 清田 正司

Hitoshi KOMAKI, Kenro MIHARA, Masashi SEITA

宮崎県立宮崎病院内科

Department of Internal Medicine, Miyazaki Prefectural Hospital

キーワード : Spleen Size, Chronic Hepatitis, Hepatitis Activity, Ultrasonography

Twenty–six patients with histologically–diagnosed chronic hepatitis (10 inactive cases, 16 active cases) were followed up using a serial ultrasonographic examination along with liver biopsies during the period of August, 1980 to July, 1988. The spleen size was estimated as a sectional area of the spleen echo using the Koga et al method, i. e. S=a×b cm² (a; maximum length of the splenotomogram, b; the longest width perpendicular to a). The patients were divided into 4 groups using serial histological changes of the liver. Group I included 7 cases with chronic inactive hepatitis. Group II had 3 cases which changed from inactive to active hepatitis. Group III had 9 cases with chronic active hepatitis. And group IV included 7 cases which changed from active hepatitis to active hepatitis with lobular disorganization or liver cirrhosis.
The average spleen size changed from 30.3±5.0 cm² to 30.3±7.8 cm² in group I (inactive→inactive), 31.3±7.1 cm² to 37.3±7.9cm² in group II (inactive→active), 37.8±10.4cm² to 38.7±13.5 cm² in group III (active→active) and 45.1±6.2 cm² to 54.2±14.3 cm² in group IV (active→active hepatitis with lobular dysorganization or liver cirrhosis). Increased spleen size was noted during the study period in 57% of group I patients, 100% of group II patients, 33% of group III patients, and 71% of group IV patients, suggesting that the patients in group II and IV showed a high incidence of progression.
Analysis of the relationship between spleen size and the degree of hepatitis activity suggested that the larger the spleen, the more active the chronic hepatitis.