高原藏族酒精性肝病的临床病理和电镜观察
作者：孙克勤 李素芝 张霞 何贵强
单位：西藏军区总医院病理科 拉萨 850003
关键词：高原；藏族；酒精性肝病；超微结构
诊断病理学杂志000211摘 要：目的探讨酒精性肝病(ALD)的超微结构特点及其与肝功能损害程度的关系。方法对20例高原藏族ALD患者行肝穿活检组织病理学观察。结果酒精性脂肪肝(AFL)、酒精性肝炎(AH)、酒精性肝硬化(ALC)常相继发生或同时存在，主要表现为肝细胞大泡性脂变，窦周纤维化，肝细胞滑面内质网增生，小叶内灶状坏死伴中性粒细胞浸润。无论肝超微结构改变轻重，均有不同程度的肝功能异常，尤其在A/G≤1的患者，上述改变较重。结论贮脂细胞的活化状态直接影响到肝病进程及肝功能异常程度。同时讨论了影响酒精性肝损害的其它因素。
分类号：R575 文献标识码：A
文章编号：1007-8096(2000)02-0110-02
Clinicopathological and Ultrastructural Studies of Alcoholic Liver Diseases in Tibetan Plateau
Sun Keqin ,Li Suzhi ,Zhang Xia
(Department of Pathology，the General Hospital of Tibet Command，Lhasa 850003)
Abstract：Objective To investigate the ultastructural characteristics of alcoholic liver disease(ALD)and the relationship between ALD and the degree of liver functional damage. Methods Liver tissues obtained by puncture biopsy were examined in 20 cases of Tibetan ALDs. Results Alcoholic fatty degeneration，alcoholic hepatitis and alcohonic liver cirrhosis always co-existed or occurred consequentially.The main pathologic changes were a focal ballooning fatty degeneration，perisinuous fibrosis and hyperplasia of smooth endoplasmic reticulum of liver cells，and focal necrosis with neutrophilic granulocyte infiltration.No matter what degree of liver damage was liver function was always abnormal，especially more severe in the patient whose A/G ratio was less 1.Conclusion The activation of fat-storing cells will directly effects on the consequence of the liver disease and the degree of liver functional damage.Other factors which involve in ALDs were also discussed.
Keywords：Tibetan Plateau Alcoholic liver disease ultrastructure
参考文献：
[1]武忠弼主编.病理学，第三版.北京：人民卫生出版社，1991：313
[2]赵静波，王泰龄，刘 霞，等.酒精性肝病与慢性病毒性肝炎的病理鉴别，诊断病理学杂志，1994,1:68
[3]孙克勤，刘 艳.高原藏族酒精性肝病的病理分析，高原医学杂志,1998,8:47
[4]范建高.脂肪肝与纤维化的关系及其机制，国外医学.消化系疾病分册,1997,17:92
收稿日期：1999-10-10
修稿日期：1999-12-01, 百拇医药
单位：西藏军区总医院病理科 拉萨 850003
关键词：高原；藏族；酒精性肝病；超微结构
诊断病理学杂志000211摘 要：目的探讨酒精性肝病(ALD)的超微结构特点及其与肝功能损害程度的关系。方法对20例高原藏族ALD患者行肝穿活检组织病理学观察。结果酒精性脂肪肝(AFL)、酒精性肝炎(AH)、酒精性肝硬化(ALC)常相继发生或同时存在，主要表现为肝细胞大泡性脂变，窦周纤维化，肝细胞滑面内质网增生，小叶内灶状坏死伴中性粒细胞浸润。无论肝超微结构改变轻重，均有不同程度的肝功能异常，尤其在A/G≤1的患者，上述改变较重。结论贮脂细胞的活化状态直接影响到肝病进程及肝功能异常程度。同时讨论了影响酒精性肝损害的其它因素。
分类号：R575 文献标识码：A
文章编号：1007-8096(2000)02-0110-02
Clinicopathological and Ultrastructural Studies of Alcoholic Liver Diseases in Tibetan Plateau
Sun Keqin ,Li Suzhi ,Zhang Xia
(Department of Pathology，the General Hospital of Tibet Command，Lhasa 850003)
Abstract：Objective To investigate the ultastructural characteristics of alcoholic liver disease(ALD)and the relationship between ALD and the degree of liver functional damage. Methods Liver tissues obtained by puncture biopsy were examined in 20 cases of Tibetan ALDs. Results Alcoholic fatty degeneration，alcoholic hepatitis and alcohonic liver cirrhosis always co-existed or occurred consequentially.The main pathologic changes were a focal ballooning fatty degeneration，perisinuous fibrosis and hyperplasia of smooth endoplasmic reticulum of liver cells，and focal necrosis with neutrophilic granulocyte infiltration.No matter what degree of liver damage was liver function was always abnormal，especially more severe in the patient whose A/G ratio was less 1.Conclusion The activation of fat-storing cells will directly effects on the consequence of the liver disease and the degree of liver functional damage.Other factors which involve in ALDs were also discussed.
Keywords：Tibetan Plateau Alcoholic liver disease ultrastructure
参考文献：
[1]武忠弼主编.病理学，第三版.北京：人民卫生出版社，1991：313
[2]赵静波，王泰龄，刘 霞，等.酒精性肝病与慢性病毒性肝炎的病理鉴别，诊断病理学杂志，1994,1:68
[3]孙克勤，刘 艳.高原藏族酒精性肝病的病理分析，高原医学杂志,1998,8:47
[4]范建高.脂肪肝与纤维化的关系及其机制，国外医学.消化系疾病分册,1997,17:92
收稿日期：1999-10-10
修稿日期：1999-12-01, 百拇医药