临床小儿外科杂志

目的对比分析胆道闭锁、婴儿肝炎综合征患儿肝组织活检病理表现,明确胆道闭锁与婴儿肝炎综合征的相关性及不同病理表现。方法收集2004年1月至 2014年1月在本院因黄疸保守治疗效果不佳而疑为胆道畸形并行胆道探查、胆道造影患儿的肝活检标本32例,其中胆道闭锁25例,婴儿肝炎综合征7例,分别就两者肝活检HE染色切片肝细胞淤胆、变性,毛胆管淤胆,汇管区胆管增生,胆管内胆栓,汇管区炎性细胞浸润,肝脏纤维化程度进行比较。结果虽然婴儿肝炎综合征胆道造影存在胆道形态异常,但同年龄段胆道闭锁与婴儿肝炎综合征患儿肝细胞淤胆、变性,毛胆管淤胆,汇管区炎性细胞浸润等情况比较无明显差异; 胆道闭锁患儿汇管区胆管增生,肝脏纤维化程度明显高于婴儿肝炎综合征组(P<0.05)。结论婴儿肝炎综合征与胆道闭锁病理表现明显不同; 汇管区胆管增生、肝纤维化程度是鉴别胆道闭锁与婴儿肝炎综合征的主要病理依据; 婴儿肝炎综合征能否最终发展为胆道闭锁尚需进一步随访研究。

Objective To comparatively analyze the differential liver histological features between biliary atresia(BA)and infantile hepatitis syndrome(IHS)and elucidate their relationship. Methods From January 2004 to January 2014, a total of 32 patients(including 25 BA and 7 medication-resistant IHS)were recruited. Cholestasis and degeneration of hepatocyte, cholestasis of bile ductile, bile ductal proliferation, bile plug and inflammatory cell infiltration in portal area, viral inclusion body and stages of liver fibrosis were examined by hematoxylin & eosin-staining slides. Results No differences existed between cholestasis and degeneration of hepatocyte, cholestasis of bile ductule or cell infiltration in portal area in BA and IHS. However, bile ductal proliferation and stages of liver fibrosis were more severe in BA than those in IHS(P<0.05).Conclusion s Marked differences of hepatic histological features exist between BA and IHS. Longer follow-ups are required for clarifying whether or not IHS evolves into BA. Bile ductal proliferation and advanced liver fibrosis in hepatic histology are two major differential points for BA and IHS.

引言
1 材料与方法
2 结果
3 讨论

图1 IHS患儿术中胆道造影显示胆道形态异常; 图2BA患儿肝组织活检显示汇管区胆管增生(HE染色 10×20)<br/>Fig.1 Abnormal morphology of bile duct on cholangiography in HIS children; Fig.2 Bile ductal proliferation in portal area in BA children(HE staining 10×20)

图1 IHS患儿术中胆道造影显示胆道形态异常; 图2BA患儿肝组织活检显示汇管区胆管增生(HE染色 10×20)
Fig.1 Abnormal morphology of bile duct on cholangiography in HIS children; Fig.2 Bile ductal proliferation in portal area in BA children(HE staining 10×20)

表1 BA与IHS患儿肝组织活检对比<br/>Table 1 Differences of hepatic histology between BA and IHS

表1 BA与IHS患儿肝组织活检对比
Table 1 Differences of hepatic histology between BA and IHS

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备注

引言

1 材料与方法

2 结果

3 讨论

期刊信息

备注

引言

1 材料与方法

2 结 果

3 讨 论

期刊信息

2 结果

3 讨论