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目的 观察慢性TT型肝炎的病理特征 ,探讨TTV的致病性。方法 9例慢性单一TT型肝炎行肝穿刺术 ,肝组织一部分经 10 %中性福尔马林固定 ,石蜡包埋 ,送光镜检查 ;另一部分经 2 %戊二醛固定 ,中性树酯包埋 ,送电镜检查。结果 9例慢性单一TT型肝炎病理和临床诊断基本相符 ,其病理变化发生率依次为肝细胞水肿、胞浆疏松化、点状坏死、嗜酸性变、嗜酸小体形成等 ,未见特殊病理改变。光、电镜检查结果可概括为四个方面 :( 1)变性坏死性改变 :是慢性单一TT型肝炎的主要病理改变 ,表现为肝细胞不同程度的浊样肿胀、嗜酸性变和点状坏死 ,部分有碎屑样坏死 ,未见到桥状坏死 ;( 2 )炎性改变 :肝实质内坏死灶区、汇管区和新形成的纤维间隔内可见到程度不等的炎症细胞浸润 ,肝窦内Kupffer细胞增生 ;( 3)纤维增生性改变 :9例慢性单一TT型肝炎中 ,仅其中 1例 ,肝组织损害较重 ,部分网状支架塌陷 ,纤维组织增生明显 ,形成间隔 ,但没有形成假小叶 ;( 4)超微结构改变 :肝细胞普遍存在线粒体肿胀 ,粗面内质网、滑面内质网肿胀或脱颗粒等。结论 慢性单一TT型肝炎的病理改变符合病毒性肝炎的一般特征 ,TTV可能有致病性 ,但其致病性较弱。
Objective To observe the pathological features of chronic hepatitis TT and explore the pathogenicity of TTV. Methods Nine patients with chronic hepatitis B were treated by hepatic puncture. One part of liver tissue was fixed with 10% neutral formalin, embedded in paraffin and examined by light microscopy. The other part was fixed with 2% glutaraldehyde. Neutral resin Buried, electron microscopy. Results The pathology and clinical diagnosis of nine chronic hepatitis B patients were basically consistent. The incidence of pathological changes followed by hepatocyte edema, loosening of cytoplasm, punctate necrosis, eosinophilic changes and eosinophilic formation. There was no special pathology change. Light and electron microscopy examination results can be summarized in four aspects: (1) degeneration and necrosis changes: chronic hepatitis type A is the main pathological changes, manifested as varying degrees of turbidity of hepatocytes swollen, eosinophilic and punctate necrosis, Part of the debris-like necrosis, did not see the bridge necrosis; (2) inflammatory changes: intrahepatic necrosis of the lesion area, portal area and the newly formed fiber interval can be seen varying degrees of inflammatory cell infiltration, sinusoidal Kupffer cell proliferation; (3) fibrosis changes: 9 cases of chronic single TT hepatitis, only 1 case of severe damage to the liver, some of the collapse of the network stent, fibrous tissue hyperplasia, the formation of intervals, but did not form a false Leaflets; (4) changes in ultrastructure: widespread mitochondrial swelling hepatocytes, rough endoplasmic reticulum, sliding endoplasmic reticulum swelling or degranulation. Conclusion The pathological changes of chronic single TT hepatitis are in accordance with the general characteristics of viral hepatitis. TTV may be pathogenic, but its pathogenicity is weak.