摘要
目的探讨原位肝移植术后HCV感染常见病理组织学特点。方法回顾性分析2000年9月-2006年9月在本中心61例明确诊断为术后HCV感染且肝功能异常患者73份肝活组织检查的病理和临床资料。结果术后HCV感染出现酶学异常的时间为9～1553 d,19例HCV RNA水平超过10^5拷贝/ml,42例HCV RNA水平10^2～10^5拷贝/ml。HCV感染的病理特点是以肝细胞变性、坏死和汇管区炎症及纤维化为主的一组病理表现。以组织学出现纤维化的时间90 d为界将其分为早期和晚期。炎细胞大量浸润和肝组织纤维化两种病变在早、晚期的发生率分别为：5．7％（2/35）和94．7％（36/38）（x^2=54．34,P＜0．01）；2．9％（1/35）和97．4％（37/38）（x^2=61．47,P＜0．01）,差异均有统计学意义。结论原位肝移植术后有症状的HCV感染多见于1周后,术后感染早、晚期有不同的组织学特点,与非移植患者有所差异。肝活组织检查对移植术后HCV感染的分期、程度评估及鉴别诊断具有重要价值。
Objective To investigate the pathological characteristics of HCV infection after liver transplantation. Methods This is a retrospective analysis of the clinico-pathological changes of 73 liver biopsies obtained from 61 patients who had HCV infection （including HCV recurrence and reinfection） after fiver transplantation in our center from September 2000 to September 2006. Results Abnormal enzyme test results due to HCV infection happened on the 9th to the 1553rd post-transplantation surgery day. The serum HCV RNA level was higher than 10^5 copies/ml in 19 cases and between 10^2-10^5 copies/ml in the other 42 cases. The histological changes in the transplanted livers were hepatocellular degeneration, necrosis and apoptosis, portal infiltrations and fibrosis. They were classified into two stages （early stage and late stage） according to the onset of fibrosis which appeared within 90 days or later after their transplantation in our study. The incidence of predominant portal infiltrates and liver fibrosis in early stage and late stage was 5.7% （2/35） and 94.7% （36/38） （x^2= 54.34, P 〈 0.01） and 2.9% （1/35） and 97.4% （37/38） （x^2= 61.47, P 〈 0.01） respectively. Conclusions Pathological features of early stage and late stage hepatitis C infection in transplanted rivers are different and they are also different from that in native livers. Liver biopsies are important in clinical staging, evaluation of the severity, and differential diagnosis of post-transplantation HCV infection.
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2007年第8期593-596,共4页
Chinese Journal of Hepatology
关键词
肝移植
肝炎
丙型
病理学
临床
Liver transplantation
Hepatitis C
Pathology, clinical
