72例隐源性肝炎肝穿活体组织检查病理分析

The Pathological Analyse of Liver Biopsy in 72 Patients with Cryptogenetic Hepatitis

目的通过肝穿活检肝组织病理,提高对隐源性肝炎的临床诊疗水平,减少漏诊及误诊。方法对72例隐源性肝炎穿刺活检组织,经10%中性甲醛固定,快速石蜡连续切片,常规HE、Massorn染色和乙型肝炎病毒抗原免疫组织化学染色,部分病理切片进行铜染色及糖原染色。结果经病理确诊为慢性乙型肝炎19例(26.4%),非酒精性脂肪性肝炎(NASH)12例(16.7%),酒精性脂肪性肝炎(ASH)4例(5.6%),假性肝炎3例(4.2%),原发性胆汁性肝硬化(PBC)2例(2.8%),Willson’s病1例(1.4%),原因不明的31例(43.1%)。结论“隐源性肝炎”中慢性乙型肝炎、NASH所占比率较高,对不明原因的肝损害患者行肝穿活检肝组织病理检查能提高诊断率。

Objective To elevate the clinical diagnostic and therapic level, and to decrease the missed diagnosis and misdiagnosis by liver biopsy.Methods 72 patients with cryptogenetic hepatitis were performed by liver biopsy. The tissue samples were fixed in formalin, sected serial sections, and stained with HE dyeing, Massom dyeing and HBV antigens immunohistochemical dyeing, parts were stained with cupmm dyeing or staining for glycogen. Results Final diagnosis： There are 19 patients （26.4%） with chronic hepatitis B, 12 （16.7%） with NASH, 4 （5.6%） with ASH, 3 （4.2%）with false hepatitis, 2 （2.8%）with PBC, 1 （1.4%）with Willson, s desease, 31 （43.1%） with cryptogenetic hepatitis. Conclusions The ratios of chronic hepatitis B and NASH were relativly high in cryptogenetic hepatitis; It can elevate the accuracy rating of clinical diagnosis for patients with cryptogenetic hepatitis by liver biopsy.