文章摘要
王爽 黄晓峰 尹文 韩英 王瑞安 李增山 李永强 亢君君 鲁亚成.非酒精性脂肪肝病肝组织超微结构特点[J].,2012,12(14):2703-2705
非酒精性脂肪肝病肝组织超微结构特点
Ultrastructural Features of Liver Tissues in Non-alcoholicFatty Liver Disease
  
DOI:
中文关键词: 非酒精性脂肪肝病  超微结构  诊断  电镜检查
英文关键词: Non-alcoholic fatty liver disease  Ultrastructure  Diagnosis  Electron microscopy
基金项目:陕西省社发攻关项目(2010K15-03-07);陕西省自然科学基金资助项目(2009JM4006)
作者单位
王爽 黄晓峰 尹文 韩英 王瑞安 李增山 李永强 亢君君 鲁亚成 第四军医大学基础医学院中心实验室 第四军医大学西京消化病医院 第四军医大学基础医学院病理学与病理生理学教研室 
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中文摘要:
      目的:阐明非酒精性脂肪肝病(NAFLD)的超微结构特点。方法:收集我校和其他单位送检的3 例单纯性非酒精性脂肪肝,16 例NASH 患者和4 例NAFLD 肝硬化患者的肝穿刺组织。用2.5%戊二醛、1%锇酸双固定、Epon 812 包埋,超薄切片70nm,醋酸铀 和柠檬酸铅染色后,JEM-2000EX 透射电镜观察。结果:单纯性脂肪肝患者主要表现为大小不等的脂滴沉积、以小脂滴为主,可互 相融合。NASH 患者的肝细胞都可出现大量脂滴积聚,为大小脂滴混合型、内容物主要为中等电子密度、比较均一的甘油三酯,部 分脂滴周围可见磷脂成分,NASH 患者肝细胞内脂滴也互相融合。肝细胞线粒体的超微结构改变包括多形性线粒体、基质颗粒增 多、线粒体增大和嵴的丧失是主要的电镜异常发现,线粒体内还可见副晶格样包涵体。部分NASH 患者肝细胞内可见Mallory 小 体。NASH 患者肝细胞周围可见淋巴细胞浸润。肝血窦Kupffer 细胞增生不明显,NAFLD 肝硬化患者Disse 间隙和肝细胞间可见 胶原纤维增生。结论:NAFLD 具有较为明确的超微结构改变,电镜检查有助于诊断。
英文摘要:
      Objective: To investigate the ultrastructural features of liver tissues in non-alcoholic fatty liver disease (NAFLD). Methods:23 cases of NAFLD were collected, included 3 cases of steatosis, 16 cases of nonalcoholic steatohepatitis (NASH) and 4 cases of liver cirrhosis. The percutaneous liver aspiration biopsy was performed, the biopsy tissues were fixed in 2.5% glutaraldehyde, postfixed in 1% osmium tetroxide,embedded with Epon 812, 70 nm ultrathin sections were prepared. Ultrathin sections were stained with uranyl acetate and lead citrate and examined with a JEM-2000EX transmission electron microscope at 80 kV. Results: The number and size of lipid droplets vary in steatosis, small lipid droplets was seen frequently and they can fuse each other. The numerous lipid droplets was found in NASH. The macrovesicular and microvesicular or mixed types of steatosis were existed in the same cell. The content of lipid droplets was mainly medium electron dense triglyceride, and phospholipid was found in the periphery of some lipid droplets. The fused lipid droplets were also found in NASH. Ultrastructural changes in mitochondria of hepatocytes included polymorphic and enlarged mitochondria,increased metrical granules, fragmentated cristae. The paracrystalline inclusions of mitochondria and Mallory body were also found in NASH. Lymphocytic infiltration is sometimes present in the in the vicinity of hepatocytes in NASH. The proliferation of Kupffer cells was not obvious. Increased collagen fibers were found in Disse spaces and intercellular spaces of hepatocytes in liver cirrhosis. Conclusions: The characteristic ultrastructural changes was found in NAFLD, electron microscopy might be of help in the diagnosis of NAFLD.
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