肝细胞凋亡与慢性乙型肝炎病毒携带者肝组织病变的关系

目的 观察慢性HBV携带者（ASC）肝组织凋亡指数及Fas、FasL的表达,探讨肝细胞凋亡在ASC肝组织病变中的作用.方法 选取HBV携带者患者120例,并进行肝组织活检.采用原位末端转移酶标技术进行肝细胞凋亡情况检测,采用免疫组织化学技术检测肝组织中的Fas、FasL.结果 120例ASC肝组织完全正常者仅占11％,轻度肝炎组占59％,而中、重度肝炎组占30％.ASC患者的凋亡指数（AI）随着炎症程度加重而升高,正常组为1.50±1.04,而中度组、重度组分别为11.33 ±1.51和17.67 ±6.42,各组间比较差异有统计学意义（P＜0.05）.肝组织免疫组化结果显示,Fas、FasL表达程度随炎症活动度加重而增强,尤其在汇管区周围碎屑状坏死区及周边小叶更明显,正常组基本无表达,而轻度组以无表达或阳性表达为主,仅见于界面炎症区的肝细胞及淋巴细胞上;中、重度肝炎组Fas、FasL则均为阳性及强阳性表达,除界面炎症区外,肝小叶中也弥漫分布.Fas强阳性表达率在中、重度组分别为34.8％和69.2％,FasL的强阳性表达率分别为30.4％和53.8％,均明显高于正常组和轻度组（P＜0.05）,同时中、重度组间比较差异亦有统计学意义,肝组织中Fas、FasL表达程度随炎症活动度加重而增强,两者间明显相关.结论 肝细胞凋亡在ASC肝组织病变的发生发展中可能起到重要作用.

Relationship between hepatocellular apoptosis and liver tissues of chronic HBV carriers of disease

Objective To observe the expression in liver tissues of patients with chronic HBV carriers （ASC） apoptosis index and Fas, FasL, and investigate the role of apoptosis in liver tissue of chron- ic HBV carriers lesions in the role. Methods Liver biopsy samples from 120 cases of ASC patients. We detected liver cell apoptosis using the method of TdT-mediated dUTP nick end labeling and the Fas, FasL in the liver tissues by immunohistochemical technique. Results 120 cases of liver tissue of chronic HBV carriers completely normal accounted for only 11%, Mild hepatitis group accounted for 59%, In severe hepatitis group, accounted for 30%. The apoptosis index （AI） were increased with the severity of inflam- mation,the AI of light, moderate, severe group respectively were （ 1.50 ± 1.04） , （ 11.33 ± 1.51 ） , （ 17.67 ±6.42 ）. Apoptosis ceils in the periportal hepatocytes and leaflets were distributed around the Portal. Immunohistochemistry showed that Fas, FasL in the normal group without expression, But the mild group with no expression or expression and the positive expression was seen in liver cells and lymphocytes in inflammatory zone on the interface. In the moderate and severe group, Fas, FasL positive and strong pos- itive expression were almost all. In addition to the interface area of hepatic lobule inflammation, also dif- fuse distribution. Fas strong positive expression rate in severe group, respectively 34.8% and 69.2%. The strong positive expression rate of FasL was 30.4% and 53.8%. The rates were significantly higher than normal group and mild group（ P 〈 0.05 ） , and the degree of inflammation activity between Fas, FasL ex- pression in liver tissue. Conclusion The Liver cell apoptosis might play an important role on the progres- sion of ASC.