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近几年来,对肝纤维化发生、发展机制的研究又有不少令人鼓舞的新进展,包括对肝内不同部位纤维生成细胞的特点、对疾病特异性肝纤维化调节机制的阐述,以及对肝纤维化自然史和可逆性的全面评价等等方面,也为诊断和治疗肝纤维化开拓了新思路和新方法,其中一些问题更是肝病学者关注的热点。 1．肝纤维化的细胞学基础：肝星状细胞(HSC)是肝脏细胞外基质(ECM)产生的主要细胞来源。当肝损伤时位于窦周Disse腔内静止状态的HSC转变成具有增殖、收缩、迁移、促进炎症和纤维生成活性的表型——肌成纤维细胞。近年来,有证据表明还存在其他不同的ECM生成细胞,它们都有独特的肝内定位、免疫组织化学和电镜下的表型,如门静脉区的成纤维细胞和肌成纤维细胞,位于血管的平滑肌细胞和中央静脉周围的肌成纤维细胞等,这些细胞在肝纤维化的发生机制中均起了重要作用。最近一些研究对肝间质细胞的来源进行了广泛的探讨。体外实验发现HSC可通过表达纤维生成基因或
In recent years, there have been a lot of encouraging new advances in the study of mechanism of development and progression of liver fibrosis, including the characteristics of fibroblasts in different parts of the liver, the mechanism of disease-specific regulation of liver fibrosis, and On the natural history of liver fibrosis and reversibility of a comprehensive evaluation, etc., but also for the diagnosis and treatment of liver fibrosis has opened up new ideas and new methods, some of which are more of liver disease scholars focus of attention. 1. Cytological Basis of Hepatic Fibrosis: Hepatic stellate cells (HSCs) are the major source of extracellular matrix (ECM) production in the liver. HSCs in the quiescent state of the Dissentral Sinus of the Sinus are transformed into phenotype-myofibroblasts that proliferate, contract, migrate, and promote inflammation and fibrogenic activity when liver injury occurs. In recent years, there is evidence that there are other different ECM-producing cells that have unique intrahepatic localization, immunohistochemical and electron microscopic phenotypes such as fibroblasts and myofibroblasts in the portal vein, Smooth muscle cells and myofibroblasts around the central vein, etc. These cells play an important role in the pathogenesis of hepatic fibrosis. Some recent studies have extensively explored the sources of liver interstitial cells. In vitro experiments found that HSC can express genes through the expression of fiber or