Study on the pathogenesis and treatment of hepatic encephalopathy
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摘要: 肝性脑病至今仍以血液检查所见的生化代谢异常来解释 ,因不能圆满解释全面情况 ,需进一步探讨。不加选择收集 70例肝硬化死亡者脑组织 ,分别作HE和免疫组化检查 ,观察病理改变和HBsAg、HBcAg表达。在70例脑组织标本中免疫组化染色HBsAg、HBcAg阳性者计 30例 ,阳性率 42 .3 % ,临床上有肝性脑病表现者阳性率明显高于无表现者 ,脑组织病理改变较明显者 ,阳性率亦明显高于较轻者。肝硬化脑组织内出现HBsAg和HBcAg表达 ,而且阳性率与脑组织病理改变和是否出现临床表现密切相关 ,提示HBV侵及脑组织 ,导致病理形态改变可能是肝性脑病的病理基础 ,生化代谢异常可能仅是肝衰的表现。Abstract: The pathogenesis of hepatic encephalopathy of cirrhosis should be studied more forward because of incapable of explaining satisfactorily hepatic encephalopathy being resulted from ammonimia or disorder of amino acid metabolism 70 specimens of brain tissue were cellected from the patients died of liver cirrhosis randomly for HE.Thionine and Holzer stains for studying its pathology, especially the neuren and neuroglia.Oedema and damages of neuron, neuroglia and smalll blood vessels could be seen in all 70 specimens, and especially, the cases with clinical hepatic encephalopathy showed more marked brain pathology than that without clinical hepatic encepholopathy in HE, thionine and Holzer stains.HBsAg and HBcAg could be demonstrated in brain tissue by immunohistochemical stain and its positive rate was correlated with both the clinical manifestation and brain pathology.So, it seems that the HBsAg and HBcAg positive in brain tissue and brain pathology might be the pathogensis base of hepatic encephalopathy and the abnormal biochemical metabolism found before is perhaps only the results of hepatic failure.
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Key words:
- Hepatic encephalopathy /
- Brain tissue stain /
- Damages of brain tissue /
- Pathogenesis base
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