HIV/AIDS患者伴发肝损伤的肝脏病理学分析  

Liver pathological analysis in human immunodeficiency virus or acquired immune deficiency syndrome patients with liver damage

作　　者：黄志忠[1] 吕建楠 覃江龙 李品超 牟敏红[4] 覃亚勤[1] Huang Zhizhong;Lyu Jiannan;Qin Jianglong;Li Pinchao;Mou Minhong;Qin Yaqin(Department of Hematology,The Fourth People's Hospital of Nanning,Nanning 530023,China;Department of Infectious Disease,The Fourth People's Hospital of Nanning,Nanning 530023,China;Department of Surgery,The Eighth People's Hospital of Nanning,Nanning 530001,China;Department of Pathology,The Fourth People's Hospital of Nanning,Nanning 530023,China)

机构地区：[1]南宁市第四人民医院肝病科,南宁530023 [2]南宁市第四人民医院感染科,南宁530023 [3]南宁市第八人民医院外科,南宁530001 [4]南宁市第四人民医院病理科,南宁530023

出　　处：《新发传染病电子杂志》2021年第4期285-288,共4页Electronic Journal of Emerging Infectious Diseases

基　　金：广西壮族自治区卫生健康委会自筹课题(Z20211129);南宁市科技局重大专项(20193008)。

摘　　要：目的探讨伴发肝损伤的HIV/AIDS患者肝脏病理学类型及其特点,为AIDS患者的肝脏疾病的诊断和治疗提供依据。方法超声引导下经皮穿刺取HIV/AIDS患者肝脏组织进行病理检查,通过苏木精-伊红、过碘酸雪夫和淀粉酶消化过碘酸雪夫染色,光学显微镜观察形态学并描述组织病理特点,结合临床病例资料对病理结果进行统计分析。结果 64例HIV/AIDS患者的肝脏病理检查表现为病毒性肝炎22例(34.4%),肝脏肿瘤23例(35.9%),药物性肝炎5例(7.8%),机会性感染7例(10.9%),非特异性病变7例(10.9%)。其中乙型病毒性肝炎例12例,丙型病毒性肝炎10例,肝细胞癌11例,弥漫大B细胞淋巴瘤8例,炎性肌纤维母细胞瘤3例,结核分枝杆菌感染2例,马尔尼菲篮状菌感染2例。结论 HIV/AIDS患者肝损伤的病因中病毒性肝炎主要为乙型病毒性肝炎和丙型病毒性肝炎,肝脏肿瘤主要为肝细胞癌和弥漫大B细胞淋巴瘤,临床上需加强对HIV/AIDS患者伴发各种肝脏疾病的诊断和治疗。Objective To investigate the pathological types and features of in HIV/AIDS patients with liver damage,and we try to provide evidence for the diagnosis and treatment of liver diseases in acquired immunodeficiency syndrome.Methods The tissues of liver were obtained from HIV/AIDS patients with liver damage for pathological examination by percutaneous puncture under ultrasonographic guidance.The pathological results were observed by light microscope after Hematoxylin-Eosin,acid-fast,periodic acid-Schiff,and digested-PAS staining.The pathological characteristics and histopathological features of the hepatic tissue were described and analyzed.Results Among the 64 HIV/AIDS patients with liver damage,the viral hepatitis were found in 22 patients (34.4%),the hepatic tumors were found in 23 patients(35.9%),the drug hepatitis were found in 5 patients(7.8%),the opportunistic infectious diseases were found in 7 patients(10.9%) and the nonspecific lesions were found in 7 patients(10.9%).The pathological findings of hepatitis B virus,hepatitis C virus,hepatocellular carcinoma,diffuse large B cell lymphoma,inflammatory myofibroblastoma,mycobacterium tuberculosis infection and talaromyces marneffei infection were 12,10,11,8,3,2 and 2 cases,respectively.Conclusion The main cause of liver damage in HIV/AIDS patients are viral hepatitis,such as hepatitis B virus and hepatitis C virus,the liver tumors are hepatocellular carcinoma and mainly diffuse large B cell lymphoma.Therefore,we need to strengthen the diagnosis and treatment of HIV/AIDS patients with various liver diseases.

关 键 词：艾滋病 肝损伤 病毒性肝炎 弥漫大B细胞淋巴瘤 病理学 

分 类 号：R512.91[医药卫生—内科学] R575[医药卫生—临床医学]