81例不明原因肝损伤肝穿病理分析

目的研究肝穿活检对不明原因肝损伤的诊断价值。方法81例不明原因肝损伤接受B超引导下肝穿活检,标本常规行光镜及电镜检查。结果77例经肝穿活检明确诊断。检出自身免疫性肝病72例（72/81,88.9%）,其中自身免疫性肝炎36例,原发性胆汁性肝硬化34例,原发性硬化性胆管炎2例。发现慢性乙型肝炎、弓形虫病、脂肪性肝炎、肝淀粉样变、血吸虫性肝损伤各1例。4例经肝穿活检未能确诊。结论肝穿活检在不明原因肝损伤的诊断中有重要价值。对不明原因肝损伤患者,应重视自身免疫性肝病的诊断。

The analysis of liver biopsy in 81 patients with obscure liver injury

Objective To explore the diagnosis value of liver biopsy in obscure liver injury. Methods Eighty-one cases of consecutive patients with obscure liver injury(April 2004 to August 2006) form our hospital were enrolled in the study.Liver biopsy was performed with the guide of ultrasonography.The tissues were processed routinely for light and electron microscopic studies. Results The distribution of the patients was 53 male,29 female,and age from 23 to 76 years.Seventy-seven(77/81,95.06%) cases were diagnosed after liver biopsy.Among them,72 cases were diagnosis as autonomic liver diseases(72/81,88.89%).The distributions of autonomic liver diseases were autonomic liver hepatitis(n=36),primary biliary cirrhosis(n=34) and primary sclerosing cholangitis(n=2).Other 5 cases included chronic hepatitis B,toxoplasmosis,fatty liver amyloigosis,and schistosomiasis.In 4 cases,the causes of liver injury were not being confirmed after liver biopsy. Conclusion We concluded that liver biopsy is the most important means in the diagnose obscure liver injury.And the autonomic liver diseases should be emphasized in obscure liver injury.