乙肝肝硬化门静脉高压性胃病的组织病理学研究

目的 研究乙肝肝硬化门静脉高压性胃病的组织病理学变化。方法取乙肝肝硬化门静脉高压症病人(A组)的全层胃壁进行HE、弹性纤维、网状纤维和胶原纤维染色，观察常规组织病理学、炎性细胞、各型纤维和血管分布的变化，并用同期胃溃疡病人(B组)的全层胃壁作对照。结果两组胃黏膜层的淋巴细胞和浆细胞的分布无差异，但是B组胃黏膜层嗜酸性粒细胞和中性粒细胞的浸润多于A组。A组黏膜层可见散在的毛细血管，其横截面积却远小于B组；A组黏膜下层静脉壁厚薄不一，静脉壁的弹性纤维增多，弹性纤维的连续性较完整，部分静脉腔内有血栓机化或伴微血栓形成；两组黏膜下动静脉横截面积差异无统计学意义。两组胃壁各层胶原纤维和网状纤维面积百分比的比较无差异。结论乙肝肝硬化门静脉高压性胃病主要的组织病理学变化为，胃黏膜内有较多的淋巴细胞和浆细胞浸润，而嗜酸性粒细胞和中性粒细胞极少；胃黏膜和黏膜下血管不扩张，胃黏膜下静脉壁厚薄不一，部分表现为动脉化，部分静脉腔内有血栓机化；胃壁内胶原纤维和网状纤维的含量正常。

Histopathology of cirrhotic portal hypertension gastropathy resulting from hepatitis B

Objective To study the histopathological features of cirrhotic portal hypertension gastropathy resulting from hepatitis B. Methods The samples of stomach wall were obtained from patients with cirrhotic portal hypertension gastropathy resulting from hepatitis (group A) for HE, elastic fiber, reticular fiber and collagenous fiber staining to observe the histopathological changes and alteration in distribution of inflammatory cells, various types of fibers and blood vessels. Meanwhile, this procedure was performed for patients with gastric ulcer (group B) who were hospitalized at in the same period of time. Results The infiltrating frequency of lymphocytes and plasmocytes in mucosa in group A was similar to that in group B. The mean gastric mucosal capillary area was significantly smaller in group A than in group B ( P =0.024). However, there was no marked difference in the mean gastric submucosal vein and artery area between the 2 groups. In group A, there were distorted submucosal vasculature and thickening of the submucosal arterialization in the submucosal veins and thrombus formation in some lumens of the veins. No significant difference was found between the 2 groups in the relative area of collagenous fiber and reticular fiber in the stomach wall. Conclusions In patients with cirrhosis and portal hypertension, there are many lymphocytes and plasmocytes infiltrating in the gastric mucosa and the gastric mucosal capillary, submucosal veins and arteries are not ecstatic. Meanwhile, there is thrombus formation in some lumens of the gastric submucosal veins and the contents of collagenous fiber and reticular fiber in the gastric wall are normal.