增殖细胞核抗原在乙型肝炎患者肝组织中的表达  

EXPRESSION OF PROLIFERATING CELL NUCLEAR ANTIGEN IN THE LIVER TISSUE OF HEPA-TITIS B PATIENTS

作　　者：郎振为[1] 李德芬[1] 金荣华[1] 李俊强[1] 

机构地区：[1]北京佑安医院

出　　处：《中华内科杂志》1995年第11期731-734,共4页Chinese Journal of Internal Medicine

摘　　要：为了解不同组织学类型病毒性肝炎组织中肝细胞的增殖状况，采用免疫组化法对１５３例乙型肝炎，包括急性重型（ＡＳＨ）３９例、亚急性重型（ＳＳＨ）２１例、慢性重型（ＣＳＨ）１１例、活动性肝硬化（ＡＣ）２２例、急性轻型（ＡＭＨ）、慢性迁延性（ＣＰＨ）和慢性活动性（ＣＡＨ）各２０例肝组织中增殖细胞核抗原（ＰＣＮＡ）进行了检测和比较。经统计学处理，ＰＣＮＡ标记指数（ＬＩ）在ＣＡＨ、ＡＭＨ和ＳＳＨ较高，在ＡＣ和ＣＳＨ最低（Ｐ＜０．０１），稀疏的ＰＣＮＡ阳性细胞散布于假小叶周边近纤维间隔处，表明其肝细胞的再生能力十分低下。在部分坏死型ＡＳＨ，残存的肝细胞仍显示出一定的增殖功能，如这些患者未迅速死亡，有可能会随着肝细胞的再生修复而存活。ＡＳＨ和ＳＳＨ存活与死亡者相比，其肝组织中的ＰＣＮＡ标记指数有极显著差别（Ｐ＜０．０１）。检测肝组织中ＰＣＮＡ可判断重型肝炎的预后。iver biopsy and autopsy specimens of 15 3 cases,hchding 39 cases of acute severe hepatits (ASH),21 cases of subacute severe hepatitis(SSH ),11 cases of chronic severe hepatitis(CSH ),22 cases of active cirrhosis (AC),20 cases of acute mild(AMH ),chronic persistent(CPH)and active hepatitis(CAH),re-spectively,were immunohistochemically stained for proliferating cell nuclear antigen(PCNA)to compare the proliferative activity of hepatocytes by using labelling index(LI ).LI is higher in CAH, SSH, and AMH than in AC and CSH(P<0.01).In the latter,LI was completely negative in most of the specimens(25/33, 75.8%)and few scattered hepatocytes positive for PCNA were found in the remaining 8 cases(8/33, 24.2%)in the area next to the fibrotic septum and varied greatly in different pseudolobules. The results showed that the proliferative activity was very low in the AC and CSH, In some cases of ASH, the residual hepatocytes still kept prominent proliferating ability;it meant that the survlved percentage would have been increased with regeneration of hepatocytes if those patients had not died early,In ASH and SSHl LI was siglificantly higher in patients who survived than in those who died(P<0. 01 ).The detec-tion of PCNA in liver tissue with severe viral hepatitis is useful for prognostic evaluation.

关 键 词：乙型肝炎 免疫组织化学 细胞核 抗原 肝 

分 类 号：R512.620.2[医药卫生—内科学] R446.62[医药卫生—临床医学]