Nakanishi Shigeo, Shiraki Katsuya, Sugimoto Kazushi, Tameda Masahiko, Yamamoto Kouji, Masuda Chiaki, Iwata Makoto, Koyama Mutsumi
First Department of Internal Medicine, Mie University School of Medicine, Mie 514-8507, Japan.
Mol Med Rep. 2010 Jul-Aug;3(4):679-83. doi: 10.3892/mmr_00000316.
In chronic liver diseases, the size of the portal lymph node and the common hepatic arterial lymph node (No. 8a LN) is often altered. The objective of this study was to investigate the relationship between the pathology of chronic liver diseases and the common hepatic arterial lymph nodes using an ultrasonographic diagnostic system. The subjects included 115 patients with hepatitis C (chronic hepatitis C, 75; liver cirrhosis C, 40), 31 patients with hepatitis B (chronic hepatitis B, 17; liver cirrhosis B, 14), 16 patients with primary biliary cirrhosis (PBC), 11 patients with autoimmune hepatitis (AIH), 29 patients with alcoholic hepatitis (Alc.LD) and 190 healthy adults with no abnormalities in liver function or inflammatory reactions (100 males and 90 females, age range 26-71 years, mean 49.2). The long and short axes of No. 8 LN were measured, and the value calculated by multiplying the two diameters was designated as the LN index (Fig. 1). The No. 8 LN appearance rate and LN index were significantly higher in the patients with hepatitis C, PBC and AIH than in the healthy subjects. When the LN index cut-off value was set to 50, alanine aminotransferase and aspartate aminotransferase were significantly higher in chronic hepatitis C (CHC) patients than in the healthy subjects. In addition, the LN and splenic indexes were significantly correlated in CHC patients, suggesting that the LX index is related to portal pressure increase with an elevation of sinusoidal pressure. The LN index after interferon therapy was significantly lower in complete responders than in non-responders. The No. 8 LN index may be closely related to the pathology of chronic liver diseases.
在慢性肝病中，肝门淋巴结和肝总动脉淋巴结（第8a组淋巴结）的大小常发生改变。本研究的目的是使用超声诊断系统研究慢性肝病的病理与肝总动脉淋巴结之间的关系。研究对象包括115例丙型肝炎患者（慢性丙型肝炎75例；丙型肝硬化40例）、31例乙型肝炎患者（慢性乙型肝炎17例；乙型肝硬化14例）、16例原发性胆汁性肝硬化（PBC）患者、11例自身免疫性肝炎（AIH）患者、29例酒精性肝炎（Alc.LD）患者以及190名肝功能或炎症反应无异常的健康成年人（男性100名，女性90名，年龄范围26 - 71岁，平均49.2岁）。测量第8组淋巴结的长轴和短轴，并将两个直径相乘计算得出的值指定为淋巴结指数（图1）。丙型肝炎、PBC和AIH患者的第8组淋巴结出现率和淋巴结指数显著高于健康受试者。当淋巴结指数临界值设定为50时，慢性丙型肝炎（CHC）患者的丙氨酸氨基转移酶和天冬氨酸氨基转移酶显著高于健康受试者。此外，CHC患者的淋巴结指数与脾脏指数显著相关，提示淋巴结指数与随着窦状隙压力升高而导致的门静脉压力升高有关。完全应答者接受干扰素治疗后的淋巴结指数显著低于无应答者。第8组淋巴结指数可能与慢性肝病的病理密切相关。
