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目的探讨免疫性肝病(ILD)和酒精性肝病(ALD)的形态学变化,为临床治疗提供形态学依据。方法猪血清注射法,连续8wk致大鼠ILD;饮用酒精200mL·L~1,8wk致大鼠ALD;在光镜和电镜下观察肝脏形态变化。结果 ILD和ALD组肝细胞膜受损。肝细胞质内脂质包含物明显增多。ILD组肝内胶原纤维明显增生,假小叶形成。肝细胞器减少;线粒体膜破损,嵴减少,贮脂细胞数目增加,胞质内α-平滑肌肌动蛋白阳性。ILD组呈现肝纤维化特征,ALD组肝组织大量局灶性坏死和肝细胞水肿;Mallory小体和嗜酸性小体形成,并且有大量炎细胞浸润。结论两种肝病形态学改变不同,治疗ILD应以抗肝纤维化为主,而治疗ALD应以活血抗炎为主。
Objective To investigate the morphological changes of immune liver disease (ILD) and alcoholic liver disease (ALD), and provide morphological evidence for clinical treatment. Methods The porcine serum was injected into pigs for 8 weeks. ILD was induced in rats by drinking alcohol 200mL·L ~ 1,8wk. The morphological changes of liver were observed under light and electron microscopes. Results The liver cell membrane was damaged in ILD and ALD groups. Liver cytoplasm lipid inclusions increased significantly. ILD group hepatic collagen fibers were significantly hyperplasia, pseudolobule formation. Hepatic organelles reduced; mitochondrial membrane damage, crest reduction, the number of fat storage cells increased, cytoplasmic α-smooth muscle actin positive. ILD group showed the characteristics of liver fibrosis, liver ALD group a large number of focal necrosis and hepatocyte edema; Mallory bodies and eosinophils formed, and a large number of inflammatory cell infiltration. Conclusion The morphological changes of the two kinds of liver diseases are different. The treatment of ILD should be based on the anti-liver fibrosis, while the treatment of ALD should be mainly blood-activating and anti-inflammatory.