甲型H1N1流感合并妊娠尸检肝脏病理改变1例并文献复习  

A Case report of liver pathologic characteristics of novel human influenza A(H1N1) infection during pregnancy and literature review

作　　者：段雪晶[1] 宫恩聪[1] 吕福东[2] 王珏[1] 李勇[1] 郭素珍[1] 金荣华[2] 李宁[2] 戴洁[1] 

机构地区：[1]首都医科大学病理系,北京100069 [2]首都医科大学附属北京佑安医院

出　　处：《北京医学》2011年第9期739-741,共3页Beijing Medical Journal

摘　　要：目的探讨甲型H1N1流感合并妊娠患者的肝脏病理变化特征。方法对2009年北京市1例重症甲型H1N1流感合并妊娠尸检病例的肝脏标本进行常规病理、超微病理形态学观察及特殊染色,并复习关于妊娠合并脂肪肝、甲型H1N1流感合并妊娠病理变化及发病机制的相关文献。结果本例肝脏病理特征为微泡型脂肪变,合并肝细胞桥接坏死,与单纯性妊娠急性脂肪肝病理改变存在着一定差异。结论甲型H1N1流感病毒感染合并妊娠急性脂肪肝可能是2009年甲型H1N1流感妊娠患者死亡的原因之一。Objective To investigate the liver pathological changes of a pregnant woman who was infected with the H1N1 virus which was confirmed by clinical diagnosis.Methods Autopsy of one deceased woman from Beijing You＇an Hospital was performed and the tissues were evaluated by multiple methods,including routine systemic examinations,HE staining,special staining,and electron microscopy study.Related papers on the pathogenesis and pathology of acute fatty liver were reviewed and the difference between pregnant woman infected with the influenza A（H1N1） virus and pregnant woman without the influenza A（H1N1） virus infection was compared.Results Bridging hepatic cell necrosis and acute fatty liver were the pathological features of pregnant woman infected with the novel human influenza A（H1N1） virus.This was different from woman with pregnancy who only had acute fatty liver.Conclusion Liver fatty lesion is more serious in pregnant woman infected with the influenza A（H1N1） virus than that in pregnant woman.This may be one of the reasons why there is a high incidence of death in pregnant patient with the novel influenza A（H1N1） virus infection.

关 键 词：甲型H1N1流感 妊娠 尸体解剖 脂肪肝 

分 类 号：R511.7[医药卫生—内科学]