乙型肝炎肝内血管病变免疫组织化学观察

Immunohistochemical studies of intrahepatic vascular lesions in hepatitis B

目的研究乙型肝炎（乙肝）肝内血管病变与肝病变的关系。方法２７０例肝活检标本取自住院乙肝患者，选择１０例大致正常肝组织作对照。石蜡包埋，４μｍ切片，除依次作ＨＥ、弹力、网状及胶原纤维染色外，另用特异性平滑肌肌动蛋白（α－ＳＭＡ）单克隆抗体进行免疫组织化学标记。结果正常肝组织α－ＳＭＡ仅在原有的肝内动、静脉及胆管壁表达。乙肝病变较轻组肝组织α－ＳＭＡ示阳性表达占７５％；乙肝病变较重及肝硬变组肝组织α－ＳＭＡ示强阳性表达占９８％，两者差异有极显著性（Ｐ＜０．００１）。结论乙肝的肝内血管病变对引起肝细胞变性坏死、肝纤维化及肝硬变有重要的作用。

Objective To study the relationship between intrahepatic vein lesions in hepatitis B with the liver damages. Methods 270 cases of liver biopsies were obtained from the patients in our hospital, and 10 cases of almost normal liver tissues were selected to be compared. The tissues were embedded with paraffin, sectioned 4 μm, and stained with HE, elastic, reticular and collagenous fibers respectively; At the same time, they were labelled with smooth muscle actin α(α SMA) monoclone antibody for immunohistochemical study. Results α SMA was expressed only in the walls of primary intrahepatic arteriae, veins and biliary ducts in normal liver tissues; and the positively expressed was 75% in the group of mild liver damage; in the group of severe liver damage and cirrhosis α SMA strongly and positively expessed was 98%( P <0 001). Conclusion The intrahepatic vessel damages in hepatitis B plays an important role in liver cells degeneration, hepatic fibrosis and liver cirrhosis.