目的 研究肿瘤坏死因子Ｉ型受体（ＴＮＦＲ１）和Ｆａｓ在乙型肝炎肝细胞凋亡中的意义。方法 用免疫组织化学方法和原位末端标记技术（ＴＵＮＥＬ试验）检测７０例各型乙型肝炎患者肝组织ＴＮＦＲ１、Ｆａｓ的表达和肝细胞凋亡情况。结果 不同类型乙型肝炎肝细胞均有ＴＮＦＲ１和 Ｆａｓ表达，其表达程度与组织学类型相关（Ｐ＜０．０５）。ＴＮＦＲ１在细胞浆和细胞膜的分布相似，而Ｆａｓ主要在细胞浆分布、ＴＮＦＲ１与Ｆａｓ在肝细胞上的表达无明显关系（Ｐ＞０．０５）。不同类型肝炎肝细胞凋亡与病变程度密切相关，Ｆａｓ的表达与肝细胞凋亡也有密切关系（Ｐ＜０．００５），但ＴＮＦＲ１的表达强弱与肝细胞凋亡程度不呈正比（Ｐ＞０．０５）。在４６例中度以上肝细胞凋亡患者中，同时伴有单纯ＴＮＦＲ１中度以上阳性者有４例（８．７％），同时伴有单纯Ｆａｓ抗原中度以上阳性者有１２例（２６．１％），而同时伴有ＴＮＦＲ１和Ｆａｓ抗原均为中度以上阳性者有２８例（６０．９％），另有２例患者ＴＮＦＲ１和Ｆａｓ在肝细胞均无明显表达（４．３５％）。结论 在乙型肝炎肝细胞凋亡中、Ｆａｓ似较ＴＮＦＲ１的作用更重要； ＴＮＦＲ１和Ｆａｓ在肝细胞的同时表达可能对肝细胞凋亡有相加作用。 Objective To study the significance of tumor necrosis factor type 1 receptor (TNFR1) and Fas in hepatocellular apoptosis in hepatitis B patients. Methods The expression of TNFR1 and Fas in hepatic tissue and hepatocyte apoptosis in 70 patients with various types of hepatitis B were detected by immunohistochemistry and TUNEL. Results The expression of TNFR1 and Fas in different types of hepatitis B hepatocytes were correlated with histological types (P <0.05). The distribution of TNFR1 was similar in cytoplasm and plasma membrane, while Fas mainly distributed in cytoplasm. There was no significant correlation between the expression of TNFR1 and Fas in hepatocytes (P> 0.05). The apoptosis of hepatocytes in different types of hepatitis was closely related to the degree of lesion. The expression of Fas was also closely related to the apoptosis of hepatocytes (P <0.005), but the expression of TNFR1 was not proportional to the degree of hepatocyte apoptosis (P> 0.05). Among 46 patients with moderate or severe hepatocellular apoptosis, there were 4 cases (8.7%) with moderate or more positive TNFR1, and 12 cases with moderate or above pure Fas antigen (26. 1%), while 28 (60.9%) patients with both moderate and positive TNFR1 and Fas were not expressed in hepatocytes (4.35%) in the other 2 patients . Conclusions In the hepatocellular apoptosis of Hepatitis B, Fas is more important than that of TNFR1. Simultaneous expression of TNFR1 and Fas in hepatocytes may have an additive effect on the apoptosis of hepatocytes.