肝功能衰竭39例患者的离体肝组织病理特点

Pathological changes of the livers from 39 patients with hepatic failure

目的了解肝功能衰竭患者的肝组织病理特点,并将病理诊断与临床诊断的结果相比较。方法选择排除肝癌的乙型肝炎病毒感染者39例,将其施行肝移植术后留下的离体肝组织行多部位切取组织标本,进行苏木精-伊红染色及网纤染色,分析其病理特点,并将病理诊断与临床诊断进行比较。结果1．39例离体肝组织标本,整个肝脏病变的范围和程度呈现相对均匀分布的特点,但是在同一取材的微观肝组织中,其病变特点可呈现不均一性。2．临床诊断为“乙肝肝硬化(活动期)”的4例肝组织病理特点均符合“活动性肝硬化”,而35例临床诊断为“慢性乙型重型肝炎”的肝组织病理符合“活动性肝硬化”者有18例、符合“慢性重型肝炎”病理诊断者仅有17例。结论临床诊断为慢性重型肝炎患者在病理学上分为坏死后肝硬化和肝脏大块坏死或亚大块坏死两种类型。

Objective To explore the pathological changes of the livers from hepatic failure （HF） patients and its association with clinical disease stages. Methods Thirty-nine patients with liver failure caused by HBV infections were investigated, and none accompanied with hepatocellular carcinoma. The sections of tissue were taken from the liver after liver transplantation and stained with hematoxylin-eosin （H＆E） or RT（reticular fiber） staining. The pathological features were analyzed and compared between the clinical and pathological diagnosis. Results 1. The range and the grade of the pathological changes were all well-proportioned in the whole liver but quite asymmetrical in the same spicemen. 2. 4 cases with clinical diagnosis of cirrhosis （active stage） were in accordance with the pathological diagnosis. Only 17 in 35cases can be pathologically diagnosed as chronic severe hepatitis （SH）, while the other 18 cases were pathologically diagnosed as cirrhosis （active stage）. Conclusion There were a great inconsistency between the clinical and pathological diagnosis.