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重型肝炎时中性粒细胞的形态改变 |
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王英杰 王宇明 李梦东 可金星 张文军 陈烯伟
摘 要 目的：观察并探讨重型肝炎时血中性粒细胞的形态变化及其意义。方法：20例重型肝炎患者血中性粒细胞标本，常规固定、包埋制片、电镜检查。结果：所有患者的中性粒细胞均有明显异常，其改变程度与患者肝衰竭分期相平行。主要包括：中性粒细胞质变性，吞噬泡欠缺，细胞器及细胞颗粒减少，线粒体肿胀，细胞核浓缩等。核面积测量、线粒体和细胞颗粒电镜计数结果与上述改变一致。结论：该结果可视为严重肝病患者中性粒细胞功能减退及其对细菌易感性显著增高的形态学证据，患者中性粒细胞超微结构异常与肝衰竭之间可能有某些互为因果关系。
主题词 肝炎；中性白细胞；显微镜检查，电子
Morphological changes of neutrophils in severe hepatitis
WANG Ying-Jie, WANG Yu-Ming, LI Meng-Dong, KE Jing-Xing, ZHANG Wei-Jun, CHEN Xi-Wei
Department of Infectious Disease, Southwest Hospital, Third Military College, Chongqing (400038)
Abstract AIM: To study the morphological changes of neutrophils in patients with severe hepatitis and discuss their significance. METHODS: 20 cases of neutrophils specimens prepared with routine methods were observed by electron microscopy. RESULTS: Abnormalities of neutrophils were observated in all patients, which paralleled closely with the stage of hepatic failure in patients. Main ultrastructrual changes included cytoplasm degeneration, want of pinocytotic vesicle and phagosone, decreased organelles and granules, mitochondria swelling, nucleus condensation, etc. Nuclear area measure, mitochondria and cell granules count were consistent with the above observation.CONCLUSION: This results could be regarded as a morphological evidence of the reduced neutrophil functions and the increased susceptibility to bacterial infection in patients with severe liver disease. A mutually causal relation may be existed between the ultrastructural abnormalities of neutrophils and the hepatic failure in severe hepatitis patients.
MeSH Hepatitis; Neutrophils; Microscopy, electron
有关肝病患者中性粒细胞异常的研究已为数不少，但大多系针对肝硬化等慢性肝病患者细菌易感性增高而进行的中性粒细胞功能研究［1～3］，对其形态改变了解尚少。本文对20例重型病毒性肝炎(重型肝炎)患者中性粒细胞超微结构进行了初步观察，以期从形态学角度为阐明中性粒细胞在重型肝炎病情演变中的意义提供实验依据。
材料与方法
1.临床资料：重型肝炎20例，系我科住院的乙型重型肝炎患者，男16例，女4例，平均年龄35.4岁。临床表现均符合1995年《病毒性肝炎防治方案》中的诊断标准。其中13例经肝组织病理检查证实本病。依患[1] [2] 下一页
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