目的　研究乙型肝炎（ ＨＢ） 肝窦病变的免疫组化表达及超微结构变化的病理意义．方法　ＨＢ 肝活检标本３００ 例， 用ＦＮ，ＬＮ，ＣｏⅣ，αＳＭＡ 及ＶＥＧＦ 单克隆抗体作免疫组化（ＳＰ 法） 染色；另对６５ 例按照电镜技术制样，作超微结构观察．结果　ＨＢ 肝窦有狭窄、阻塞、扩张及肝窦毛细血管化４ 种病变． ＡＨＢ 以肝窦狭窄及阻塞较重者占多数（９５ ％ ） ，而ＣＨＢ 则以肝窦扩张及毛细血管化最明显，两者差异显著（ Ｐ＜ ０－０１） ．肝窦狭窄时肝细胞水肿、微绒毛断裂、线粒体畸型、窦内皮细胞增生或损伤，窗孔减少，基膜物质增多，以αＳＭＡ，ＶＥＧＦ 强表达较前者显著（ Ｐ ＜ ０－０１） ． ＦＮ ，ＬＮ，ＣｏⅣ及αＳＭＡ 表达随肝窦扩张程度升降，与ＶＥＧＦ 表达明显不同（ Ｐ＜ ０－０１） ． 肝窦内皮细胞可出芽形成管腔，基膜物质增多而ＶＥＧＦ 则下降．结论　肝窦病变免疫组化及超微结构变化与ＨＢ 演变有关． Objective To study the immunohistochemical expression and ultrastructural changes of hepatic sinusitis in patients with hepatitis B (HB). Methods Thirty-two liver biopsy specimens were stained with FN, LN, CoⅣ, αSMA and VEGF monoclonal antibody (SP method), and the other 65 cases were prepared according to electron microscopy Structure observation. Results Hepatic sinusoids were stenosed, obstructed, dilated and hepatic sinusoid-4 pathological changes. AHB accounted for the majority of sinusoidal stenosis and obstruction accounted for the majority (95%), while the CHB was the sinusoidal dilatation and capillary vascularization was the most significant difference between the two (P <0-01). Hepatic sinusoidal edema, microvilli rupture, mitochondrial malformation, sinus endothelial cell proliferation or injury, the window is reduced, the basement membrane substances increased to α  SMA, VEGF strongly expressed more significantly than the former (P <0-01). The expression of FN, LN, CoⅣ and αSMA increased with the degree of hepatic sinusoidal expansion, which was significantly different from that of VEGF (P <0-01). Sinusoidal endothelial cells can bud into the lumen, increased basement membrane material and VEGF decreased. Conclusion The immunohistochemistry and ultrastructure changes of sinusoidal lesions are related to the evolution of HB.