[慢性重型乙型肝炎患者肝脏的组织病理学变化]
[Histopathological changes in livers of patients with chronic severe hepatitis B].
作者信息
Zhang Li-jie, Wang Tai-ling, Liu Xu-hua, Zu Ke-jia, Meng Xin, Wang Yue, Duan Zhong-ping
机构信息
Department of Pathology, Beijing You'an Hospital, Affiliated to Capital University of Medicine, Beijing 100069, China.
出版信息
Zhonghua Gan Zang Bing Za Zhi. 2007 May;15(5):323-5.
OBJECTIVE
To investigate the histopathological features in livers of chronic severe hepatitis B (CSHB) patients.
METHODS
Histology of 42 livers was studied. HE, Masson, Sweet and D-PAS staining and cytokeratin 7, CD68 and proliferating cell nuclear antigen immuno-histochemical staining were used in the study.
RESULTS
In CSHB, the livers showed massive or submassive necrosis in a background of other histological changes of chronic hepatitis B. The characteristic pictures of these livers were necrosis of all the hepatocytes in some nodules, while in other nodules there were only patchy necroses of the parenchyma. In some other nodules the necrotic hepatocytes were all removed and only the scaffolding stroma remained. Meanwhile, regeneration of hepatocytes and bile ductules were also seen.
CONCLUSIONS
The liver histopathological changes in CSHB are identical, but not of the same degree as those of acute severe and subacute severe hepatitis B. In making differential diagnoses for liver aspiration biopsies of these patients, this fact should be kept in mind.
目的
研究慢性重型乙型肝炎（CSHB）患者肝脏的组织病理学特征。
方法
对42例肝脏组织进行组织学研究。研究采用苏木精-伊红（HE）染色、马松（Masson）染色、斯威特（Sweet）染色和过碘酸雪夫（D-PAS）染色，以及细胞角蛋白7、CD68和增殖细胞核抗原免疫组织化学染色。
结果
在慢性重型乙型肝炎中，肝脏在慢性乙型肝炎其他组织学改变的背景下呈现大片或亚大片坏死。这些肝脏的特征性表现为部分结节内所有肝细胞坏死，而其他结节内仅实质呈灶状坏死。在其他一些结节中，坏死的肝细胞全部被清除，仅留下支架性间质。同时，可见肝细胞和胆小管再生。
结论
慢性重型乙型肝炎的肝脏组织病理学改变相同，但程度与急性重型和亚急性重型乙型肝炎不同。在对这些患者的肝脏穿刺活检进行鉴别诊断时，应牢记这一事实。
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