摘要
目的：探讨慢性病毒性肝炎肝组织炎症活动度、纤维化程度和肝细胞病变形态学特征的差异。方法：按１９９５年全国慢性肝炎诊断标准，对２２４例慢性肝炎患者的肝穿刺组织进行炎症活动度分级和纤维化分期；采用免疫组化法检测组织切片的乙型肝炎表面抗原（ＨＢｓＡｇ）、乙型肝炎核心抗原（ＨＢｃＡｇ）及丙型肝炎病毒（ＨＣＶ）核心抗原（ＣＰ１０），并据此将患者分为乙型肝炎病毒（ＨＢＶ）组、ＨＣＶ组及ＨＢＶ＋ＨＣＶ组，比较各组患者炎症活动度分级、纤维化分期、肝细胞脂肪变性、细胞内淤胆、嗜酸小体及毛玻璃样肝细胞的差异。结果：ＨＣＶ组患者的炎症活动度、纤维化程度及肝细胞内淤胆均较ＨＢＶ组重。ＨＢＶ＋ＨＣＶ组患者的炎症活动度及纤维化程度介于ＨＢＶ和ＨＣＶ组之间，而肝细胞内淤胆比单独感染组轻。毛玻璃样肝细胞仅出现于ＨＢＶ感染者中；脂肪变性及嗜酸小体在各组间无显著差异。结论：ＨＣＶ引起的肝脏炎症活动度及纤维化程度较ＨＢＶ重；合并感染的病变不比单独感染重；肝细胞内淤胆可能是肝损伤加重的重要因素之一。
Background/Aims: To explore the differences in inflammatory activity, fibrosis and morphological characteristics in chronic viral hepatitis. Methods: The inflammatory activity and fibrosis of liver biopsies taken from 224 patients with chronic hepatitis were determined according to 'the diagnostic criteria of chronic hepatitis in Chinese, 1995'. HBsAg, HBcAg and hepatitis C virus (HCV) core protein (CP10) were detected on paraffin sections by immunohistochemistry. Pantients were divided into hepatitis B virus (HBV), HCV and HBV+ HCV groups and compared in several histopathological characteristics such as inflammatory activity, fibrosis, steatosis, intrahepatic cholestasis, Councilman bodies and ground-glass hepatocytes. Results: HCV group had more severe inflammatory activity, fibrosis and intrahepatic cholestasis than HBV group. The degree of inflammatory activity and fibrosis of HBV +HCV group was moderate, but the intrahepatic cholestasis was most modest among the three groups. Ground-glass hepatocytes only appeared in HBV infected cases. There was no difference in steatosis and Councilman bodies among the three groups. Conclusions: The inflammatory activity and fibrosis of hepatocytes induced by HCV are more serious than those in HBV, and the lesions are not more serious in dual infection than in single infection. Intrahepatic cholestasis may play an important role in deteriorating hepatocytic injury.
出处
《胃肠病学》
2001年第2期72-74,共3页
Chinese Journal of Gastroenterology
基金
上海市医学发展基金重点研究项目(No.99ZDI001)资助
关键词
针吸活组织检查
纤维变性
免疫组织化学
Hepatitis B, Chronic
Hepatitis C, Chronic
Biopsy, Needle
Fibrosis
Immunohistochemistry
