摘要
目的观察非酒精性脂肪性肝炎的临床病理特征。方法对临床与病理确诊的非酒精性脂肪性肝炎的肝组织进行光镜观察,并对相应的临床资料进行分析。结果大部分患者有乏力、纳差、右上腹胀满不适及丙氨酸转氨酶、天冬氨酸转氨酶、γ-谷氨酰转肽酶、胆固醇、甘油三酯升高,肥胖与非酒精性脂肪性肝炎相关,肝组织病理分析,G125例、G218例、G37例、G42例,其中S112例、S24例、S31例、S41例,有肝组织病理改变,光镜下可见到位于Ⅲ带的大泡性或大泡性为主的脂肪变性,肝细胞核位于细胞的边缘,汇管区无界面性炎;邻近的肝细胞从肿胀变性至气球样变;肝纤维化程度多较轻微,可观察到腺泡3区的窦周纤维化,少数病例可见汇管区周围细短纤维间隔,典型的M llory小体少见。结论非酒精性脂肪性肝炎是一种较为常见的、具有一定临床与病理特点的慢性肝病,肝穿活检有助于早期明确诊断。
Objective To observe the pathological and clinical characters of nonalcoholic steatohepatitis （NASH）. Methods Liver biopsy tissues taken from 52 patients with NASH were observed by routine light microscopic examination and the clinical data of patients with NASH were analyzed. Results Most patients with NASH had fatigue and weakness, anorexia, right epigastric distention, high levels of alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, γ-glutamyltranspeptidase, cholesterols, triglycerides were found in most patients with NASH. There was a correlation between obesity and nonalcoholic steatohepatitis. Histological lesions could be accounted for G1 in 25 patients, G2 18 patients, G3 7 patients, G4 2 patients, S1 12 patients, S2 4 patients, S3 1 patient, S4 1 patient. The pathological characterstics of lesions in NASH patients included maerovesicular steatosis or major macrovesicular steatosis in liver biopsy specimens, the hepatoeyte cytoplasm were be replaced largely by fat which displaced the nucleus to the margin of the cell,but not with portal district inflammation, adjacent hepatocytes from swoln to Ballooning degeneration ; the degrees of fibrosis were mild i the fibrosis of hepatic sinusoidal wells can be seen in zone 3 of lobules ,connective tissue stains show a fibrous rim round centrilobular veins in some cases,Rare Mallory bodies can be seen. Conclusion NASH is a common form of chronic liver disease with certain clinic-pathological features. LiVer biopsy is the essential methods to enhance the value of early diagnosis in patients with NASH.
出处
《东南国防医药》
2006年第6期417-420,共4页
Military Medical Journal of Southeast China
基金
福建省漳州市科技局资助项目(Z04094)
关键词
非酒精性脂肪性肝炎
肝活检
病理
临床
Nonalcoholic steatohepatitis
Liver biopsy
Pathology
Clinical
