亚急性重症肝炎黄疸形成的肝脏组织学改变

本文通过组织学、组织化学及连续切片等方法研究了亚急性重症肝肝炎的肝脏组织学改变,认为胆管扭曲,假胆管是盲端等组织学改变是造成亚急性重症肝炎淤胆的一个因素。结合临床资料,把亚急性重症肝炎发病过程分为三个时期:1.血清转氨酶增高期,2.组织增生期,3.胆汁淤滞坏死期。提出胆汁性凝固性坏死这一概念并做描述。认为淤胆造成胆汁性凝固性坏死是亚急性重症肝炎发病过程的一个重要病理过程,对“胆酶分离”作了解释。

THE HEPATIC HISTOPATHOLOGIC CHANGES AND THE DEVELOPMENT OF JAUNDICE IN SUBACUTE SEVERE HEPATITIS

Histopathologic changes in liver were studied on autopsy materials from 5 patients dead of severe subacute hepatitis (SSH) , 1 patient of acute severe hepatitis and 1 of non-hepatic disease. Apart from routine HE staining, histochemistry and serial section techniques were employed. On the basis of the findings observed under light microscope, the authors proposed that distortion of biliary canals and bliand-ending of pseudo - biliary canals were among the factors responsible for the cholestasis of SSH. The clinico-pathological manifestations of SSH might be arbitrarily divided into 3 stages: 1 . ascension of serum transaminase, 2 . proliferation of liver tissues and3.cholestasis and necrosis. In the last stage above,a special feat ure, the' chole - coagulative necrosis',was newly recognized and described as a distinct lesion. Its development might be an important pathogenesis process secondary to cholestasis in SSH. An explanation to the phenomenon of' jaundice- transaminase discrepancy' was also postulated in this paper.