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目的对比分析胆道闭锁、婴儿肝炎综合征患儿肝组织活检病理表现,明确胆道闭锁与婴儿肝炎综合征的相关性及不同病理表现。方法收集2004年1月至2014年1月在本院因黄疸保守治疗效果不佳而疑为胆道畸形并行胆道探查、胆道造影患儿的肝活检标本32例,其中胆道闭锁25例,婴儿肝炎综合征7例,分别就两者肝活检HE染色切片肝细胞淤胆、变性,毛胆管淤胆,汇管区胆管增生,胆管内胆栓,汇管区炎性细胞浸润,肝脏纤维化程度进行比较。结果虽然婴儿肝炎综合征胆道造影存在胆道形态异常,但同年龄段胆道闭锁与婴儿肝炎综合征患儿肝细胞淤胆、变性,毛胆管淤胆,汇管区炎性细胞浸润等情况比较无明显差异;胆道闭锁患儿汇管区胆管增生,肝脏纤维化程度明显高于婴儿肝炎综合征组(P<0.05)。结论婴儿肝炎综合征与胆道闭锁病理表现明显不同;汇管区胆管增生、肝纤维化程度是鉴别胆道闭锁与婴儿肝炎综合征的主要病理依据;婴儿肝炎综合征能否最终发展为胆道闭锁尚需进一步随访研究。
Objective To compare and analyze the pathological manifestation of liver biopsy in children with biliary atresia and infantile hepatitis syndrome and to clarify the relativity and different pathological manifestations of biliary atresia and infantile hepatitis syndrome. Methods Thirty-two biopsies from children with suspected biliary tract deformity who underwent conservative treatment of jaundice in our hospital from January 2004 to January 2014 were included in this study. Thirty-two cases of biliary atresia, including 25 cases of infantile hepatitis Seven patients were enrolled in the study. Hepatic cholestasis, degeneration, cholestasis of cholestasis, ductal hyperplasia in portal area, intrahepatic cholangiocarcinoma, inflammatory cell infiltration in portal area and hepatic fibrosis were compared respectively. Results Although biliary tract abnormalities existed in cholangiogram of infantile hepatitis syndrome, there was no significant difference between the same age group of biliary atresia and hepatocyte cholestasis, degeneration, cholestasis in cholangiocarcinoma and inflammatory cell infiltration in portal area The bile duct hyperplasia and hepatic fibrosis in portal area in children with biliary atresia were significantly higher than those in infants with hepatitis syndrome (P <0.05). Conclusion The pathological manifestations of infant hepatitis syndrome and biliary atresia are obviously different. The degree of bile duct hyperplasia and hepatic fibrosis in the portal area is the main pathological basis for the identification of biliary atresia and infant hepatitis syndrome. Whether the infant hepatitis syndrome can eventually develop into biliary atresia needs further Follow-up study.