摘要
目的分析自身免疫性肝炎-原发性胆汁性胆管炎(AIH-PBC)重叠综合征的组织病理学变化,提高对AIHPBC重叠综合征的临床及病理学特征的认识。方法对10例AIH-PBC重叠综合征患者的肝穿刺组织病理资料进行回顾性分析。结果 AIH-PBC重叠综合征患者多发于中年女性(80%),肝组织病理变化兼具界面性肝炎,桥接样坏死及小胆管减少甚至消失。结论自身免疫性肝病在中国人中日趋增多,AIH-PBC重叠综合征并非罕见,其诊断需综合临床表现、生化、免疫指标和组织学变化,重叠综合征兼具AIH和PBC的组织病理学特征,均可见肝小叶界面炎,且多为中重度,可见桥接样坏死及小叶中央融合性坏死,肝细胞炎症活动度从中度到重度不等,纤维化程度从S2到S4,同时均有不同程度的小胆管病变,其中3例有明显胆管数目减少,2例有细小胆管增生。
Objective To analyze the histopathologieal changes of autoimmune hepatitis （AIH） primary biliary cholangitis （PBC） overlap syndrome and to improve the understanding of its clinical and pathological features. Methods The pathological changes of liver tissue in 10 patients with AIH PBC overlap syndrome were retrospectively analyzed. Results The AIH PBC overlap syndrome was more common in middle aged women （80G） presenting with clinical and pathological characteristics of both AIH and PBC. Interface hepatitis, bridging necrosis and central confluence necrosis were all observed. The inflammatory activity of the liver tissue was from moderate to severe and fibrosis score was from $2 to $4. At the same time, different degrees of small bile duct lesions were observed, including 3 cases with obvious bile ducts decrease and 2 cases with small bile duct hyperplasia. Conclusion Diagnosis of AIH PBC overlap syndrome should be based on the clinical presentation and changes in biochemistry, immunology and histology. The overlap syndrome has the histopathologieal features of both AIH and PBC, with main histological changes of interface hepatitis, bridging necrosis and small bile duct reduction.
作者
尧颖
高建鹏
王辉
张志波
翟慧勤
徐智媛
YAO Ying;GAO Jian peng;WANG Hui;ZHANG Zhi bo;ZHAI Hui qin;XU Zhi yuan(Department of Gastroenterology,Yanan Hospital Affiliated Kunrrzing Medical University,Kunrrzing,Yunnan,Chin;Department of Gastroenterology,TILe Second Affiliated Hospital,Kunrrzing Medical University,Kunming,Yunnan,China)
出处
《肝脏》
2018年第9期769-771,共3页
Chinese Hepatology
基金
云南省昆明市卫计委卫生科技项目资助(2017-03-03-001)
