慢乙肝患者肝微循环的超微结构病变及其与肝功能障碍的关系

Correlation between hepatic microcirculation ultrastructural changes and hepatic dysfunction in chronic hepatitis B

The author observed the ultrastructural changes of hepatic microcirculation and the function of the liver in 41 cases with chronic hepatitis B confirmed histologically. The main ultrastructural changes found in patients were swelling of the endothelium of hepatic sinusoids, hyperplasia of Kupffer cells and decrease of fenestrae in the endothelium. Proliferation of monocytes and fat-storing cells was also found in the lumina of hepatic sinusoids and space of hepatocytes and perisinusoid. The basement membrane in hepatic sinusoids and the base of hepatocytes were formed in the patients with marked pathologic changes of the liver, especially in CAH with cirrhosis. The observations also showed that whatever extent of hepatic microcirculation changes, all of them had more or less elevation of SGPT and ZnT or TT. As soon as hepatic function was impaired slightly, there occurred hepatic dysmicrocirculation. But in the cases of severe ultrastructural hepatic dysmicrocirculation serum gamma globulin elevation values and A/G ratio exchanges were much higher than those in the cases of slight changes. There was some significance on the judgment of sick condition, slight or severe. Values of the elevation of serum gamma globulin and A/G ratio exchanges were much more obvious than SGPT, ZnT and TT changes. These findings suggest that the extents of pathological changes and dysfunction of the liver in chronic viral hepatitis B are correlated to the extent of hepatic microcirculation impairment. So in the treatment of chronic hepatitis early administration of medicine to improve the liver microcirculation should be considered.