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通过对18例急性、亚急性重型病毒性肝炎(甲型和乙型各9例)肝细胞坏死与肝内淋巴细胞浸润关系的观察,探讨病毒性肝炎所致肝细胞坏死的机理,认为除与 T 淋巴细胞直接侵入,杀伤带有病毒抗原的肝细胞外,尚可能与其他一些因素有关,对此从五方面进行了分析和讨论。有关病毒性肝炎(主要是乙型肝炎)肝细胞坏死的机理已进行了大量研究,普遍认为是由于 T 淋巴细胞杀伤带有肝炎病毒抗原的肝细胞所致。因此从理论上讲肝小叶的坏死区内应看到淋巴细胞与肝细胞表面接触及侵入肝细胞内的现象,肝细胞的坏死程度应与淋巴细胞的浸润程度相一致。但在实际观察重型病毒性肝炎的肝脏切片时,发现有些病例在广泛坏死的肝叶内仅见很少的淋巴细胞浸润。为此,我们对此问题进行了研究,以期对肝炎所致肝细胞坏死的机理有更进一步的认识。
Through the observation of the relationship between hepatocellular necrosis and infiltration of intrahepatic lymphocytes in 18 cases of acute and subacute severe viral hepatitis (9 cases of type A and B), the mechanism of liver cell necrosis caused by viral hepatitis was investigated. T lymphocytes directly invade and kill the liver cells with virus antigens may be related to other factors, which are analyzed and discussed from five aspects. Numerous studies have been conducted on the mechanism of hepatocellular necrosis of viral hepatitis, mainly hepatitis B, which is generally believed to be caused by T lymphocytes killing hepatocytes with hepatitis antigen. Therefore, in theory, the necrotic area of hepatic lobule should see the contact of lymphocytes with the surface of hepatocytes and invade the hepatocytes. The necrosis degree of hepatocytes should be consistent with the degree of infiltration of lymphocytes. However, in the actual observation of liver slices of severe viral hepatitis, some cases were found to have only a few lymphocytic infiltrates in the extensively necrotic liver lobes. To this end, we conducted a study on this issue, with a view to hepatitis A mechanism of liver cell necrosis have a better understanding.