非酒精性脂肪性肝炎肝穿刺临床病理分析

Nonalcoholic steatohepatitis: a clinicopathological analysis of liver biopsy in 32 cases

目的观察非酒精性脂肪性肝炎(NASH)肝穿刺临床病理特征,并对其诊断和鉴别诊断进行分析。方法收集32例NASH的肝穿刺标本及临床资料,通过HE染色及特殊染色观察其组织学特点,并进行病理分级。结果轻度NASH患者中气球样变肝细胞及窦周纤维化少见,中-重度患者中气球样变肝细胞及窦周纤维化,随着病理分级升高而加重;脂肪性肝硬化时脂变的肝细胞数量及小叶内炎细胞均减少。结论病理组织学诊断对于鉴别轻度NASH及中重度NASH有重要价值,正确的NASH分级有助于预后判断及临床干预。

Objective To investigate the clinicopathological features of nonalcoholic steatohepatitis （NASH） and elucidate its diagnosis and differential diagnosis. Methods Liver biopsy tissues and clinical data of 32 patients with NASH were collected and the clinicopathological findings by HE and Masson staining were evaluated for NASH grading, Results Ballooning degeneration of the liver cells and fibrosis around hepatic sinusoid was scarce in mild NASH cases and increased in moderate to severe cases. Steatotic and inflammatory cells in the liver lobes decrease in liver cirrhosis related to seatohepatitis, Conclusion Ballooning degeneration of the liver cells and fibrosis around the hepatic sinusoid have important value in differential diagnosis of mild from moderate to severe NASH, and correct histological grading benefits clinical intervention and prognostic evaluation of NASH.