特发性门静脉高压的肝脏病理学分析  

Liver pathology in idiopathic portal hypertension

作　　者：刘霞[1] 王泰龄[1] 项灿宏[3] 彭向欣[2] 王跃[1] 陈念[4] 张敏[1] 

机构地区：[1]中日友好医院病理科,北京100029 [2]中日友好医院感染科,北京100029 [3]中日友好医院普通外科,北京100029 [4]中日友好医院健康教育科,北京100029

出　　处：《中华肝脏病杂志》2007年第5期374-377,共4页Chinese Journal of Hepatology

摘　　要：耳的观察特发性门静脉高压的肝脏病理改变,明确病理诊断标准,并探讨临床病理联系。方法收集中日友好医院2005年1月-2007年3月病理确诊的特发性门静脉高压病例29例,对其肝组织行HE、网织纤维加Masson三色染色,以及α-平滑肌肌动蛋白、细胞角蛋白7、细胞角蛋白19免疫组织化学染色,并分析病变特点。结果29例中男9例,女20例。临床有门静脉高压、脾大等症状、体征。23例临床误诊为肝硬化。主要病理改变有：明显的汇管区纤维化,伴终末门静脉细小分支闭锁（缺乏）及不完全细纤维隔形成。部分门静脉支扩张并疝入小叶内。肝细胞萎缩及结节状再生相伴。结论特发性门静脉高压的肝脏病变具有一定的形态学特征,汇管区纤维化、门静脉小支闭锁,部分门静脉分支疝入肝实质,肝细胞萎缩及结节状再生相伴,较具诊断价值。Objective To study the histopathological changes of livers in idiopathic portal hypertension （IPH）. Methods Liver specimens from 29 cases with idiopathic portal hypertension were studied. Histological preparations of the livers were stained with haematoxylin eosin and Masson＇s trichrome; reticular fibers in the liver tissues were demonstrated. The slides were also stained using some immunohistochemistry methods, and the pathological changes of the livers were analyzed. Results The characteristic changes found in these IPH livers were dense portal fibrosis; obliteration, with or without phlebitis, of the branches of the portal vein; dilatation of the sinusoids; atrophy and nodular hyperplasia of liver cells. Conclusions Histopathological changes of the livers in IPH are dense portal fibrosis, portal vein branch obliteration and nodular hyperplasia of liver cells. These are the main features for a histopathological diagnosis of IPH.

关 键 词：病理学 特旋性门静脉高压 

分 类 号：R686[医药卫生—骨科学]