肝组织病理学检查在婴儿胆汁淤积症鉴别诊断中的价值  

Value of histopathologic examination in differential diagnosis of infantile cholestasis

作　　者：刘艳[1] 黄志华[1] 徐三清[1] 黄永建[1] 周华[1] 董永绥[1] 冯杰雄[2] 

机构地区：[1]华中科技大学同济医学院附属同济医院儿科,湖北省武汉市430030 [2]华中科技大学同济医学院附属同济医院儿外科,湖北省武汉市430030

出　　处：《世界华人消化杂志》2012年第23期2200-2204,共5页World Chinese Journal of Digestology

摘　　要：目的:对比胆道闭锁与淤胆性婴儿肝炎的肝组织病理学的异同点,探讨肝组织病理学检查在鉴别诊断中的实际应用价值.方法:将我院2002-04/2009-12经病理诊断的胆道闭锁65例与淤胆性婴儿肝炎病例24例进行回顾性分析.结果:胆道闭锁与淤胆性婴儿肝炎肝组织病理学均可表现为肝小叶结构变化、肝细胞变性坏死、汇管区炎症、胆汁淤积、汇管区纤维化、胆管增生、巨细胞样变和髓外造血.其中胆道闭锁以汇管区纤维化、胆管增生及汇管区炎症最常见(P<0.05),而淤胆性婴儿肝炎则以巨细胞样变及髓外造血最常见(P<0.05).结论:胆道闭锁与淤胆性婴儿肝炎肝组织病理学各有特点,但有一定的重叠性.在诊断时仍需结合临床,必要时行剖腹探查.AIM： To compare differences in liver histopathology between extrahepatic biliary atresia（EHBA） and infantile cholestatic infantile hepatitis（IH） and to explore the value of liver histopathologic examination in differential diagnosis of these diseases.METHODS： The clinical data for 65 patients with EHBA and 24 patients with IH who were pathologically diagnosed from April 2002 to December 2009 were retrospectively analyzed.RESULTS： There were some common histopathologic features between EHBA and IH.The major histopathological features of EHBA were bile duct proliferation,portal fibrosis and inflammatory cell infiltration（all P 〈 0.05）,while the outstanding features of IH were hepatic giant cell transformation and extramedullary hematopoiesis（both P 〈 0.05）.CONCLUSION： Although there are some differences between EHBA and IH in histopathologic features,some features are overlapped.Therefore,clinical features for the patients should also be considered.In some cases,exploratory laparotomy is required for differential diagnosis.

关 键 词：胆汁淤积 病理学检查 肝外胆道闭锁 淤胆性婴儿肝炎 

分 类 号：R725.7[医药卫生—儿科]