慢性乙型肝炎及肝硬化患者肝脏微循环改变

为探讨慢性乙型肝炎（慢乙肝）及肝硬化患者的肝脏微循环状态。对141例慢乙肝、12例肝硬化患者和2例正常人的肝组织进行HE染色，光镜观察，并对其中53例慢乙肝和2例肝硬化患者的肝组织进行了电镜观察。结果显示，正常人的肝窦腔通畅，无狭窄和闭塞，无红细胞聚集现象。慢乙肝患者86.52%有肝窦腔狭窄，60.28%肝窦腔内见红细胞聚集,34.04%肝窦腔内有血栓形成；电镜观察见94.34%的患者肝窦内皮细胞窗孔减小减少，33.96%有基底膜形成,24.53%狄氏腔内出现胶原纤维。肝硬化患者肝组织结构紊乱，肝腺泡消失，假小叶形成。提示慢乙肝患者存在肝脏微循环障碍，肝硬化时肝脏微循环结构丧失。

Changes of hepatic microcirculation in patients with chronic hapatitis B and liver cirrhosis

To observe the morphologic changes of hepatic microcirculation in patients with chronic hepatitis B or liver cirrhosis.141 patients with chronic hepatitis B,12 cases of liver cirrhosis and 2 cses of controls were studied.The morphologic changes were observed with microscope and transmission electron microscope(TEM).Results showed that the hepatic sinusoids were clear in controls,without stenosis.of 141 patients with chronic hepatitis B,stenosis of hepatic sinusoids were found in 86.52% cases,aggregation of red blood cells in hepatic sinusoids in 60.28% cases,development of thomb in 34.04% cases.With TEM,it was found that the number of the fenestrea on sinusoidal endothelial cells were decreased and their sizes were also decreased in 94.34% cases,subendothelial cells membrane was developed in 33.96% cases,and collagen fibers were deposited in the space of Disse in 24.53% cases.The liver acinus disappeared in cirrhotic livers.These changes suggest that hepatic microcirculation disorders exist in patients with chronic hepatitis B and hepatic microcirculation structures disappear in cirrhotic livers.