慢性丙型肝炎15例患者的临床及病理分析

目的探讨慢性丙型肝炎病理组织学改变特点及肝组织损伤程度与丙型肝炎病毒（HCVRNA）载量的关系.方法对15例散发的慢性丙型肝炎患者进行血常规、肝功能、肝胆脾B超检查,同时在B超引导下进行肝组织活检,观察镜下肝组织损伤特点,判断其炎症分级和纤维化分期,并对肝组织活动指数进行Knodell系统评分.结果肝功能指标、脾脏厚度、门静脉宽度、肝组织活动指数在HCVRNA阳性和阴性组无明显差异;肝组织病变以汇管区炎症细胞浸润、淋巴滤泡形成占多数,伴有肝细胞脂肪变、嗜酸性变及界面炎症.结论丙型肝炎肝组织炎症程度与病毒载量无明显关系;淋巴细胞聚集、淋巴滤泡形成及汇管区扩大在慢性丙型肝炎发病中具有重要意义;肝细胞嗜酸性变、脂肪变、界面炎症在丙型肝炎肝损伤中常见.

Analysis the clinical pathological changes of 15 patients with chronic hepatitis C

Objective To investigate the pathological features of chronic hepatitis C,to study the relation of the pathological changes of liver tissues and HCVRNA leveles.Methods The scattered 15 cases with chronic hepatitis C were collected.The blood roution,liver funcation of biochemistry index and examed their liver,gallbladder,and spleen by supersonic B were taken.The inflamation grades G and fibrosis stages S under the microscope were observed and the scores of histological activity index(HAI) were given according to Knodell.The liver function of biochemistry index and HAI were compared between the HCVRNA positive group and negative one.Results The liver function of biochemistry index,thickness of spleed,width of portal vein(PV) and HAI were not different between HCVRNA positive group and negative one.Histological features of majority patients were lymphocyte aggregation/follicle within the portal tracts,steatosis,mallory body and interface inflammation.Conclusion The histological changes of hepatitis C is caused by immunity.It is not related to HCVRNA levels.Lymphocyte aggregation/follicle within the portal tracts and bile tube damage are very important in chronic hepatitis C.Steatosis,mallory body and interface inflammation are frequent histological changes.