晚期血吸虫病患者肝细胞核内嗜酸性包涵体的观察

对155例晚期血吸虫病病例肝脏活检组织进行病理观察,并检测肝内乙肝表面抗原(HBsAg)和乙肝核心抗原(HBcAg)。结果,88例(56.8％)乙肝抗原(HBAg)阳性;30例(19.4％)肝细胞核内存在嗜酸性包涵体,其中18例(60％)HBAg也阳性。这些包涵体可能是巨细胞病毒、单纯疱疹病毒等肝内感染的标志。肝内HBAg或包涵体阳性患者的肝实质病变显著加重。表明合并其它病毒的肝内感染也可加重晚期血吸虫病的肝脏病变,并可能是发生门脉性肝硬化的原因之一。

Observation on eosinophilic intranuclear inclusions in hepatocytes of patients with advanced schistosomiasis japonica

Wedge biopsies of liver from 155 patients with advanced schistosomiasis japonica were observed pathologically, and HBsAg and HBcAg in liver were tested with double bridge peroxidase-anti-peroxidase (PAP) method. 88 of 155 cases (56.8%) were found to be HBsAg and/or HBcAg (HBAg) positive in liver. Eosinophilic intranuclear inclusions were observed in the hepatocytes of 30 cases (19.4%), in which 18 (60%) were also HBAg positive in liver. These inclusions were considered to be the markers of several virus infections, such as cytomegalovirus, herpes simplex virus, etc. The patients with positive HBAg and/or inclusion in liver had significantly more severe pathological changes in liver parenchyma. The results indicate that in addition to hepatitis B, complication with other viral infections in liver, which produce eosinophilic intranuclear inclusion, may also aggravate the pathological changes in liver and may be one of the causes of portal cirrhosis in patients with advanced schistosomiasis japonica (Fig. 1). schistosomiasis japonica