Iakhontova O I, Dudanova O P
Ter Arkh. 1992;64(2):10-5.
Chronic liver diseases are marked by a well-defined relationship between the intensity of the cytolytic syndrome and the level of circulating immune complexes (CIC). The highest damaging action on hepatocytes is produced by medium-sized CIC because of their penetrating and complement fixing effects. The level of thrombocytopenia and, to a less measure, of leukopenia also depends on the concentration and size of CIC in CAH and liver cirrhosis (LC), which may provide indirect evidence of the lytic action of CIC on hepatocytes, leading in turn to the impairment of microcirculation and aggravation of hepatocyte hypoxia. The data obtained attest to the role CIC of varying size play in the pathogenesis of CAH and LC. The changes in the properties of immune complexes induced by the derangement of cellular membranes also influence the course of immune responses, favouring an increase of antibody formation. As a result of an appreciable suppression of antibody and medium-sized CIC formation enhancing the cytolytic syndrome, the preference during glucocorticoid treatment should be given to the use of the medium doses of prednisolone which ensure less intensity and less duration of cytolysis as compared to the application of large drug doses.
慢性肝病的特征是细胞溶解综合征的强度与循环免疫复合物（CIC）水平之间存在明确的关系。中等大小的CIC对肝细胞产生的损伤作用最大，因为它们具有穿透和补体固定作用。血小板减少症的程度以及白细胞减少症程度较轻，也取决于慢性活动性肝炎（CAH）和肝硬化（LC）中CIC的浓度和大小，这可能间接证明了CIC对肝细胞的溶解作用，进而导致微循环受损和肝细胞缺氧加重。所获得的数据证明了不同大小的CIC在CAH和LC发病机制中的作用。细胞膜紊乱引起的免疫复合物性质变化也会影响免疫反应过程，有利于抗体形成增加。由于抗体和增强细胞溶解综合征的中等大小CIC形成受到明显抑制，糖皮质激素治疗期间应优先使用中等剂量的泼尼松龙，与大剂量药物应用相比，其可确保细胞溶解的强度和持续时间更低。
