乙型肝炎肝纤维化及肝硬变的动态观察

Dynamic observation on liver fibrosis and cirrhosis of hepatitis B

目的研究乙型肝炎纤维组织增生的动态变化．方法对１８３８例肝活检样进行组化、免疫组化、电镜观察，并对其中１１０例２次以上随访的肝活检样本作了追踪研究．结果急性期网状、胶原纤维轻微增生，而慢性期则以胶原、弹力纤维（重型）占优势，特别在肝硬变期为显著（Ｐ＜００１），表明其呈梯度变化；在纤维组织动态变化中，血管增生及纤维化、ＦＮ，ＬＮ，ⅣＣｏ，αＳＭＡ表达也随之升降；随访研究表明，增生的纤维组织是可逆的，但降解吸收较缓慢．

AbstractAIM To study the dynamic changes of proliferational fibrous tissues on hepatitis B.METHODS In 1838 cases of liver biopsies of hepatitis B, histochemistry, immunohistochemistry and electron microscope were performed. At the same time, 110 cases of them with more than 2 followup liver biopsies were compared.RESULTS There was minimal proliferation of reticular and collagenous fibers during acute stage, while during chronic stage, collagenous and elastic fibers (heavy) were significant especially during cirrhosis stage (P<0.01), with gradient change. The vascular proliferation and fibrosis, the expression of FN, LN, CⅣ and α-SMA also changed. The followup studies showed that the proliferation of fibrous tissues was reversible, but the degradation was slow.CONCLUSION Liver fibrosis from hepatitis B is reversible.