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终末肝静脉的形态测定。2. 对长期喂食酒精的狒狒进行随访。

Morphometry of terminal hepatic veins. 2. Follow up in chronically alcohol-fed baboons.

作者信息

Porto L C, Chevallier M, Grimaud J A

机构信息

Institut Pasteur CNRS UA 602, Lyon, France.

出版信息

Virchows Arch A Pathol Anat Histopathol. 1989;414(4):299-307. doi: 10.1007/BF00734083.

Abstract

Alcohol induced perivenular fibrosis of terminal hepatic veins (THV) is claimed to be a precursor lesion leading to fibrosis development in man and baboon. The nature and significance of the THV lesions found in four baboons chronically fed with alcohol were studied in liver biopsies obtained during a three year period. The surface of THV wall and the number of mesenchymal cells were assessed with a semi-automatic image analyser. Histologically, THV were characterized as (a) phlebitic, in the presence of an inflammatory cell infiltrate involving the venous wall; (b) oedematous, when the connective tissue of the THV wall was disrupted or dissociated and (c) fibrotic, when perivenular scarring appeared as an increased rim. These lesions were present simultaneously and their intensity and distribution were independent of the duration of alcohol intoxication. Morphometric data obtained from these THV confirmed the thickening of the THV wall (WS/IS in: oedematous 1.05 +/- 0.36; phlebitic 1.65 +/- 1.04; fibrotic 1.47 +/- 0.36); and revealed an increased number of mesenchymal cells in fibrotic (439 microns 2/cell; p less than 0.01) and in phlebitic THV (510 microns 2/cell; p less than 0.05). A constant relationship was found between phlebitis and the presence of inflammatory infiltrate within the hepatic acini. Fibrotic THV was a less frequent finding and the lesion disappeared in the sequential biopsies of one of the baboons. In conclusion, THV lesions were heterogeneous and the collagen deposition in the THV wall was potentially reversible during the three year alcohol intoxication period, regardless the inflammatory reaction and, thus, did not indicate early irreversible hapatic fibrosis.

摘要

酒精性终末肝静脉(THV)周围纤维化被认为是导致人类和狒狒纤维化发展的前驱病变。在三年期间获取的肝活检组织中,对四只长期喂食酒精的狒狒中发现的THV病变的性质和意义进行了研究。使用半自动图像分析仪评估THV壁的表面和间充质细胞的数量。组织学上,THV的特征为:(a)静脉炎型,存在累及静脉壁的炎性细胞浸润;(b)水肿型,当THV壁的结缔组织被破坏或分离时;(c)纤维化型,当静脉周围瘢痕形成表现为边缘增加时。这些病变同时存在,其强度和分布与酒精中毒的持续时间无关。从这些THV获得的形态学数据证实了THV壁增厚(水肿型:壁表面积/内径面积为1.05±0.36;静脉炎型为1.65±1.04;纤维化型为1.47±0.36);并显示纤维化型THV(439平方微米/细胞;p<0.01)和静脉炎型THV(510平方微米/细胞;p<0.05)中间充质细胞数量增加。发现静脉炎与肝腺泡内炎性浸润的存在之间存在恒定关系。纤维化型THV较少见,在其中一只狒狒的连续活检中病变消失。总之,THV病变是异质性的,在三年的酒精中毒期间,THV壁中的胶原沉积可能是可逆 的,无论炎症反应如何,因此并不表明早期不可逆性肝纤维化。

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