目的探讨急性乙型肝炎肝血管炎症、阻塞及破坏与预后的关系．方法用临床及组织学随访、组化、免疫组化及电镜技术，对１５８例急性乙型肝炎肝活检标本血管炎症、阻塞及破坏的特征作了观察．结果在乙型肝炎急性期，肝血管炎症、阻塞及破坏的程度与肝细胞的变性坏死、胆汁分流及预后有关：在１０６例急性乙型肝炎较轻组，被累及的为门管及肝窦，其炎症及破坏程度较轻，患者皆获得临床治愈；而在较重组、急性及亚急性重型肝炎组则与其相反，病死率分别占５％，１００％及４３％（Ｐ＜００５～００１）．结论肝血管受累的大小及程度是发病机制及预后的重要标志 Objective To investigate the relationship between hepatic vascular inflammation, obstruction and destruction and prognosis in acute hepatitis B Methods The characteristics of vascular inflammation, obstruction and destruction in 158 cases of acute hepatitis B liver biopsy specimens were observed by clinical and histological follow-up, histochemistry, immunohistochemistry and electron microscopy. The results in the acute phase of hepatitis B, the degree of hepatic vascular inflammation, obstruction and destruction with the degeneration and necrosis of liver cells, bile shunt and prognosis: 106 cases of acute hepatitis B mild group, were involved in portal and sinusoidal , The degree of inflammation and destruction was lighter, and patients were clinically cured. In the severe group, acute and sub-acute severe hepatitis group were the opposite, the mortality rates were 5%, 100% and 43% (P <005 ~ 0  01). Conclusion The size and extent of hepatic vascular involvement are important markers of the pathogenesis and prognosis