肝内血管病变与肝炎病变关系的研究

Study on the relationship between intrahepatic vascular diseases and hepatitis

目的 研究肝血管病变与肝损伤的关系．方法 肝病变标本２０００ 例，用ＨＥ、免疫组化及电镜技术进行研究．结果 在急性肝炎肝血管炎症、破坏及阻塞随肝坏死加重而上升（ Ｐ＜ ０－０１） ；在慢性肝炎肝血管炎症、破坏、阻塞及增生随肝病变的轻重程度而示梯度变化（ Ｐ＜ ０－０１） ；在肝硬变肝血管增生及纤维化最明显，与结节大小及纤维带宽窄相关（ Ｐ＜ ０－０１） ，伴弹力纤维化． 免疫组化示纤维带、血管内皮细胞及成肌纤维细胞αＳＭＡ 强阳性； 电镜示血管内皮细胞出芽并形成管状结构．

AIM To study the relationship between intrahepatic vascular diseases and liver injury. METHODS Two thousand liver specimens of hepatic diseases were studied with HE, histochemistry, immunohistochemistry and electron microscopy. RESULTS Intrahepatic vascular inflammation, damage and obstruction increased with the enhancement of hepatic necrosis in acute hepatitis ( P <0 01), while in chronic hepatitis, intrahepatic vascular inflammation, damage, obstruction and proliferation changed gradiently with the severity of hepatic diseases ( P <0 01). And in liver cirrhosis, intrahepatic vascular proliferation and fibrosis were significant, which was related with the size of node and the width of fibrous zone ( P <0 01), and elastic fibrosis. Immunohistochemistry showed that α SMA was strongly positively expressed in fibrous zones, vascular endotheliocyte and myofibroblast. Electron microscope showed that vascular endotheliocyte germinated and formed a tubular structure. CONCLUSION Intrahepatic vascular diseases play a key role in various hepatic pathologic changes.