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目的：探讨Fas／FasL途径介导的肝细胞凋亡在丁型肝炎重型化机制中的作用。方法：采用免疫组化双重染色和连续切片技术，检测48例丁型肝炎病人肝组织了型肝炎病毒抗原HDAg、Fas／FasL表达，以54例乙型肝炎作疾病对照。结果：Fas以肝细胞浆表达为主，HDAg以核浆型表达为主，两抗原表达及分布有相关性。FasL主要表达在浸润淋巴细胞浆、肝细胞核，与HDAg表达及分布不全一致，丁型肝炎Fas、FasL检出率及表达强度较对照组高，HDAg、Fas、FasL3成分在各型肝炎中的表达强度有显著性差异。结论：HDV感染可诱导肝细胞表达Fas，细胞毒T淋巴细胞（CTL）通过Fas／FasL途径介导的肝细胞凋亡在丁型肝炎病情重型化机制中可能有重要作用。
Objective: To investigate the role of Fas / FasL pathway-mediated hepatocyte apoptosis in the mechanism of severe hepatitis D infection. Methods: Immunohistochemical double staining and serial sections technique were used to detect the expression of HDAg, Fas / FasL in 48 cases of hepatitis B patients with hepatitis B virus and 54 cases of hepatitis B as controls. Results: Fas was predominantly expressed in hepatocyte cytoplasm, while HDAg was mainly expressed in nucleus pulposus. The expression and distribution of two antigens were correlated. FasL was mainly expressed in infiltrating lymphocyte plasma and hepatocyte nucleus, which was consistent with the abnormal expression and distribution of HDAg. The positive rate of Fas and FasL in hepatitis D was higher than that in control group. The expression of HDAg, Fas and FasL3 in various types of hepatitis There are significant differences in the intensity. CONCLUSION: HDV infection can induce the expression of Fas in hepatocytes. The apoptosis of hepatocytes induced by HDL-infected CTL through Fas / FasL pathway may play an important role in the mechanism of severe hepatitis D infection.