摘要
目的观察乙型肝炎肝内血管阻塞性病变与肝纤维化之间的关系．方法对１０７９例乙型肝炎的肝活检标本静脉阻塞作了观察．并对肝组织中网状、胶原、弹力纤维作组织化学及ＦＮ、ＬＮ作免疫组化染色（ＡＢＣ法）．结果肝纤维化指数随肝内血管阻塞的轻（２９４±１５６）、中（５０８±１３０）、重度（６６３±１９７）而上升．在血管阻塞轻度组６１％无纤维带形成，其较窄占３９％，而中度组较窄占５１％，较宽占４９％（Ｐ＜００１），重度组较窄仅７８％，而较宽则占９２２％（Ｐ＜００１）．其Ｆｉ组织病理学有高度的区域性差异，且与被阻塞的静脉相伴随；新形成的纤维带由毛细血管所构成；桥接性纤维化由新形成的小血管相连接；肝硬变的纤维带构成与血管损伤相一致．结论乙型肝炎肝纤维化及肝硬变由肝内静脉阻塞所致．
AIM To study the relationship between vascular obstructive lesions and fibrosis of hepatitis B. METHODS Liver biopsies from 1079 patients with hepatitis B were studied with HE, histochemical and immunochemical stain. RESULTS Hepatic fibrosis indexes were increased with the degrees of mild (2 94±1 56), moderate (5 48±1 30) and severe (6 63±1 97) in the liver vascular obstruction ( P <0 01). In the group of mild vascular obstruction, no fibrous band was found in 61%, and narrow fibrous bands accounted for 39%; while in the moderate group, broad and narrow fibrous bands covered 51% and 49%, respectively; and 7 8% and 92 2% ( P <0 01) in the severe group. Histopathological distribution of hepatic fibrosis varied from one region of the liver to another and accompanied by vascular occlusion. The newly formed fibrous bands were composed of capillaries. Bridging fibrosis was linked up by newly formed capillaries. The formation of fibrous septa in cirrhosis was in accordance with vascular lesions. CONCLUSION Fibrosis and cirrhosis were caused by intrahepatic venous thrombosis in hepatitis B patients.
关键词
乙型肝炎
肝血管阻塞疾病
肝纤维化
病理
hepatic veno occulusive disease/complications
hepatitis B/complications
liver cirrhosis/etiology
