Shimada H, Nihmoto S, Matsuba A, Nakagawara G
First Department of Surgery, Fukui Medical School, Japan.
J Clin Gastroenterol. 1988 Apr;10(2):197-200. doi: 10.1097/00004836-198804000-00019.
We studied the histology of the liver in acute cholangitis to determine whether microscopic changes corresponded to the patients' clinical status. Thirty-four cases of acute cholangitis were divided clinically into mild and severe cases. The incidence of endotoxemia, gram-negative bacteremia, disseminated intravascular coagulation (DIC), and hepatic failure were significantly higher in the severe cases than in the mild ones. In the severe cases, the incidence of neutrophile infiltration into the sinusoids (12 of 16) and microabscesses in the lobules (11 of 16) was also significantly higher than in the mild cases. Finally, the incidence of portal thrombosis (10 of 16) and massive necrosis of the hepatic cells (5 of 16) was significantly higher in the severe than in the mild cases, especially in the patients who later died. The results suggest that neutrophilic infiltration into the sinusoid and microabscesses in the lobules is a characteristic finding in severe cholangitis.
我们研究了急性胆管炎患者肝脏的组织学情况，以确定微观变化是否与患者的临床状况相符。34例急性胆管炎患者在临床上被分为轻症和重症。重症患者内毒素血症、革兰氏阴性菌血症、弥散性血管内凝血（DIC）及肝衰竭的发生率显著高于轻症患者。重症患者中，窦状隙嗜中性粒细胞浸润（16例中有12例）及小叶内微脓肿形成（16例中有11例）的发生率也显著高于轻症患者。最后，重症患者门静脉血栓形成（16例中有10例）及肝细胞大片坏死（16例中有5例）的发生率显著高于轻症患者，尤其是在后来死亡的患者中。结果表明，窦状隙嗜中性粒细胞浸润及小叶内微脓肿形成是重症胆管炎的特征性表现。
