乙型慢活肝患者肝组织内乙肝病毒抗原表达与病变程度的关系  

The relationship between the expression of HBV antigen and patho - logical lesions of liver tissues in patients with chronic active hepatits B

作　　者：乔汉臣[1] 孙屹峰[1] 李灵敏[1] 高文军[1] 毛乾国[1] 张广文 刀文彬[2] 

机构地区：[1]河南卫辉市新乡医学院第一附属医院,453100 [2]北京地坛医院病理科

出　　处：《世界华人消化杂志》1994年第3期152-153,134,共3页World Chinese Journal of Digestology

摘　　要：目的:通过肝穿刺病理学检查,研究慢活肝患者肝组织内HBsAg及HBcAg的麦达与肝脏病理损害的关系。方法:40例乙型慢活肝患者血清HBV标志物检测,采用固相放射免疫法,肝穿刺活检标本采用HE及Masson染色法检查肝组织病理损害程度。肝组织内HBsAg及HBcAg表达的检测采用双桥PAP法。结果:肝组织病理损害较重的中型及重型慢活肝患者,肝组织内HBsAg表达多呈胞浆包涵体型及膜型(74 3％,26/35);5例轻型慢活肝中4例为均质型,无1例属胞浆包涵体型者。中型慢活肝患者肝细胞内HBcAg表达半数呈弥漫型和膜型(51.5％,16/31);4例重型慢活肝患者肝细胞内HBcAg表达均属弥漫型和膜型,轻型慢活肝无1例呈此两种表达者。结论:肝细胞内HBsAg表达呈胞浆包涵体型和膜型,HBcAg呈弥漫型和膜型者,由于易受免疫攻击,肝脏病理损害较为重。单纯核型HBcAg者肝损害轻,且少见。AIM The expressions of HBsAg and HBcAg in liver tissues and the relationship between the expression patterns and pathologicallesions of liver tissues were studied.METHODS Hepatits B virus markers in serum were determined by solid phase radioimmunoassay in 40 patients with chronic activehepatits B(CAH).The HE stain and masson stain were used in examination of liver pathological changes.The expressions of HBsAgand HBcAg in hepatic cells were determined using double-bridge PAP method.RESULTS The expression of HBsAg in hepatic cells mostly was membranous pattern and cytoplasmic inclussion pattern in middleand severe CAH(74.3 %,26/35),and 4 patients were diffusion pattern in 5 patients with mild CAH(80 %).The expression ofHBcAg in hepatic cells was diffusion pattern and membranous pattern in about half patients with middle CAH(51.5%,16/31).TheHBcAg expression of 4 patients was diffusion and membranous patterns in 5 patients with severe CAH,but the diffusion andmembranous patterns of HBcAg expression weren't observed in 4 mild CAH patients.CONCLUSIONS In CAH patients with cytoplasmic inclusion pattern and membranous pattern of HBsAg expression,and withdiffusion and membranous patterns of HBcAg expression,the pathological lesions of liver are sevre.In the patients with nuclearpattern of HBcAg,the liver lesions are slighter and scarcer.It is suggested that HBsAg and HBcAg are target antigen of immunecompetent cells.

关 键 词：慢性活动性肝炎 乙型肝炎病毒 免疫病理学 肝组织 

分 类 号：R512.62[医药卫生—内科学]