目的：探讨肝组织病理学分级评分在肝外胆道闭锁( biliary atresia, BA)与婴儿肝炎综合征( infantile hepatitis syndrome, IHS)鉴别诊断中的意义。方法收集经活检确诊的34例BA及16例IHS病例,对其进行回顾性分析,重新对胆汁淤积、肝细胞损害、胆管增生、汇管区纤维化、肝细胞及汇管区炎细胞浸润、髓外造血、汇管区水肿、肝细胞巨细胞变等主要的肝组织病理学变化进行分级评分,总分24分。每例依次对上述8个病理学参数进行打分,最后统计总分。结果 BA组及IHS组肝组织病理学总评分差异有统计学意义(P<0．001)。其中胆管增生、汇管区纤维化、汇管区水肿、肝细胞巨细胞变4个病理学参数在BA组及IHS组之间差异有显著性(P<0．001)。结论对BA及IHS主要的肝组织病理学变化进行分级评分有助于二者之间的鉴别诊断。%Purpose To study the values of liver histopathological assessment grading score in differential diagnosis between biliary atresia ( BA) and infantile hepatitis ( IHS) . Methods Thirty four cases of BA and sixteen cases of IHS were analyzed retrospectively, which were diagnosed by biopsy. A hepatic histopathological assessment grading score was developed. This consisted of eight features such as cholestasis, hepatocellular damage, bile duct proliferation, portal edema, portal inflammation, portal fibrosis, extramedullary hemopoiesis and multinucleated giant hepatocytes. The total scores were 24 points. All the cases were assessed one by one. Results The total scores of BA were significantly higher than that of IHS (P<0. 001). The frequencies of bile duct proliferation, portal fibrosis and portal edema were significantly higher in BA than that in IHS group, while the frequency of multinucleated giant hepatocytes was significantly higher in IHS than that in BA group. Conclusions This scoring system is helpful in differentiating BA from IHS.
展开▼
