肝活检病理学指标在肝硬化门静脉高压症诊断中的应用  

Application of pathological indicators based on liver biopsy in the diagnosis of cirrhotic portal hypertension

作　　者：许雅洁 尤文铮 任万雷 龙泉河 姜相君[2] 胡豆豆[2] XU Yajie;YOU Wenzheng;REN Wanlei;LONG Quanhe;JIANG Xiangjun;HU Doudou(Graduate School of Dalian Medical University,Dalian,Liaoning 116044,China;Second Department of Gastroenterology,Qingdao Municipal Hospital,Qingdao,Shandong 266000,China;Department of Gastroenterology,Qingdao Municipal Hospital,Qingdao,Shandong 266000,China;Department of General Surgery,Qingdao Municipal Hospital,Qingdao,Shandong 266000,China;First Department of Traditional Chinese Medicine,Qingdao Central Hospital Affiliated to Qingdao University,Qingdao,Shandong 266042,China)

机构地区：[1]大连医科大学研究生院,辽宁大连116044 [2]青岛市市立医院消化内二科,山东青岛266000 [3]青岛市市立医院消化内科,山东青岛266000 [4]青岛市市立医院普外科,山东青岛266000 [5]青岛大学附属青岛市中心医院中医一科,山东青岛266042

出　　处：《临床肝胆病杂志》2021年第12期2935-2938,共4页Journal of Clinical Hepatology

基　　金：国家自然科学基金青年基金(81800543)。

摘　　要：肝静脉压力梯度(HVPG)是诊断门静脉高压症以及判断其严重程度的“金标准”,但因其有创性、操作技术难度大,限制了其在临床中的广泛开展。通过非侵入性方法替代HVPG是目前研究的热点,但现有的血清学及影像学方法的准确度仍有待商榷,尚不能在临床中完全替代HVPG。肝活检已在临床中广泛开展多年,是确诊某些肝脏疾病不可或缺的方法。近来研究发现肝穿刺后的病理学指标,如胶原面积、纤维间隔厚度、结节大小、微血管密度及胆管、淋巴管密度和面积等,不仅能判断肝纤维化的严重程度,而且与门静脉压力也有良好的相关性。这对诊断肝硬化门静脉高压症及评估门静脉高压症严重程度提供了新的思路。Hepatic venous pressure gradient(HVPG)is the“gold standard”for diagnosing portal hypertension and determining its severity,but its wide clinical application is limited due to its invasiveness and difficulties in operation.The replacement of HVPG by noninvasive methods has become a research hotspot in recent years;however,the accuracy of the existing serological and imaging methods remains to be discussed,and such methods cannot completely replace HVPG in clinical practice.Liver biopsy has been widely used in clinical practice for many years and is still an indispensable method for the diagnosis of some liver diseases.Recent studies have found that several pathological indicators after liver biopsy,such as collagen area,fibrous septal thickness,nodule size,microvascular density,and density and area of bile ducts and lymphatic vessels,can not only judge the severity of liver fibrosis,but also have a good correlation with portal venous pressure,which provides new ideas for diagnosing cirrhotic portal hypertension and evaluating the severity of portal hypertension.

关 键 词：肝硬化 高血压 门静脉 活组织检查 针吸 诊断 

分 类 号：R575.2[医药卫生—消化系统]