单纯胆囊结石之肝脏病理学改变

Pathological Studies of Liver in Patients with Simple Gall一Stones

应用光镜、扫描电镜对单纯胆囊结石患者的肝活组织进行观察研究。结果发现：尽管病人临床上无肝功能损伤表现，但肝脏有不同程度的损伤，表现为早期的肝细胞水变性和随病程延长而加重的肝汇管区、肝窦和中央静脉纤维组织增生，严重者甚至出现早期肝硬化征象，且临床和病理观察均无明显胆汁淤积表现，说明纤维增生与淤胆无关．增生的胶原部分来自贮脂细胞，井可能由肝细胞合成，这提示肝损伤可能有免疫反应参与．指出单纯胆囊结石虽然临床上无肝功受损表现，但不可忽视患者肝脏的潜在性损伤．

he operative liver biopsy in patients with simple gall一stones was observed and studied by using optic and electronic microscopes. The results showed that there was injury of differ- ent degrees is these liver tissues, although the patients didn'thave clinical manifestations of liV-er dVsfunction. In the primary stage, this injury showed hydropic degeneration in hepatocytes and fibrohyperplasia which was more and more severe in the portal area, hepatic sinusoid and central vein as time goes on. In some serious cases even early hepatocirrhos is occurred. These patients didn't manifest cholestasis in tlie clinic and pathology,so the fibrohyperplasia had no relation with cholestasis. Some collagen flbers in hyperplasia were from fat storing cells and the others may be composed by hepatocytes. It suggests that the injury of hepatocytes may be related to immunoreaction. Although patients with simple gallstones didn't have liver dysfunction, its hidden injury shouldn't be neglected.