慢性肝炎肝窦毛细血管化的临床病理研究

Clinicopathological analysis of the development of hepatic sinusoidal capillarization in chronic hepatitis patients

目的观察慢性肝炎患者的肝窦毛细血管化与其病理改变、血清学指标相关性,以进一步探索肝窦毛细血管化在疾病诊疗中的意义。方法符合入选条件的68例慢性肝炎患者,行肝穿刺活组织病理检查,用免疫组化方法进行CD34染色,显示肝窦毛细血管化的程度。并于当日晨采血检测肝功能、肝纤维化四项,进行相关性分析。结果肝窦毛细血管化程度与血清肝功能指标中GGT明显相关(r=0.385,P<0.01);与血清肝纤维化指标中的HA显著相关(r=0.502,P<0.001);与肝组织炎症分级、纤维化分期呈正相关,与分期相关性更强(分别为r=0.426,P<0.01;r=0.569,P<0.001)。结论血清学肝功能指标中单独GGT异常预示存在着不断进展的肝损伤;HA是判断肝窦毛细血管化与肝纤维化的一个灵敏的无创性指标;肝窦毛细血管化可能在某种意义上加剧了肝组织炎症的进展。

Objective To investigate the relationship between the development of hepatic sinusoidal capillarization and pathological change and the serological markers in chronic hepatitis patients.Methods Tissues were obtained from 68 chronic hepatitis patients and 6 liver-disease free patients.Expression of CD34 was examined by immunohistochemical technique to show the development of hepatic sinusoidal capillarization.The results were correlated with clinicopathological parameters.Results The level of hepatic sinusoidal capillarization in chronic hepatitis patients correlated significantly with inflammation grade and fibrosis stage in hepatic tissue.The expression of hepatic sinusoidal capillarization was correlated closely with the levels of GGT and HA.Conclusion These data showed that GGT and HA response hepatic sinusoidal capillarization in chronic hepatitis patients and hepatic fibrosis hepatic sinusoidal capillarization aggravate the level of liver inflammation.