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目的观察乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)合并脓毒症肝脏病理改变。方法选择50例HBV-ACLF肝移植患者的移植前肝脏标本,制成石蜡切片,经HE染色、Masson三色染色和抗细胞角蛋白-7(CK-7)免疫组织化学染色,镜下观察肝脏病理变化。结果 HBV-ACLF合并脓毒症的病理改变为在肝硬化基础上发生大块/亚大块坏死,部分肝硬化结节残留,结节边缘细胆管扩张,腔内有浓缩胆汁,细胆管上皮细胞萎缩甚至消失。结论 HBV-ACLF合并脓毒症时肝脏表现为残留结节边缘细胆管胆汁淤积,但需要注意与其他类型的胆汁淤积鉴别。
Objective To observe the liver pathological changes of hepatitis B-associated chronic and acute liver failure (HBV-ACLF) complicated with sepsis. Methods The pre-transplantation liver samples from 50 patients with HBV-ACLF liver transplantation were selected and made into paraffin sections. The liver tissues were stained by HE staining, Masson’s trichrome staining and anti-cytokeratin-7 (CK-7) Pathological changes. Results The pathological changes of HBV-ACLF complicated with sepsis were massive / sub-massive necrosis on the basis of cirrhosis, partial hepatic cirrhosis nodules, fine bile duct dilatation at the edge of nodules, concentrated bile and bile duct epithelium Shrink or even disappear. Conclusion HBV-ACLF with liver sepsis in patients with residual nodular edge of choledocholedicular cholestasis, but the need to pay attention to identify with other types of cholestasis.