目的:探讨不同时期肝硬化中医证候与其肝脏窦周隙胶原纤维沉积程度的相关性。方法将肝硬化患者分为临床前代偿期、临床代偿期、失代偿期三组,并与慢性肝炎组、非肝病组进行对照,利用腹腔镜或开腹手术获取肝组织,在透射电镜下观察窦周隙胶原纤维沉积程度。结果肝硬化患者中均见窦周胶原纤维沉积表现(20/20,100.0%),其中重度者失代偿期中占71.4%(5/7)、代偿期中占33.3%(3/9)、临床前代偿期中占25.0%(1/4);瘀血阻络证在肝硬化患者中占55.0%(11/20)、重度胶原纤维沉积者中占66.6%(6/9)、轻度者占45.4%(5/11)。结论窦周隙胶原纤维沉积程度可能随肝硬化临床前代偿期、临床代偿期及失代偿期的进展而逐渐加重,窦周隙胶原纤维沉积程度与中医瘀血阻络证有一定的相关性。
Objective To explore the correlation of TCM patterns/ syndromes in different stages of liver cirrhosis with the severity of collagen fiber deposition in liver perisinusoidal space. Methods The pa-tients of liver cirrhosis were divided into a preclinical compensation group,a clinical compensation group and a decompensation group and were compared with chronic hepatitis group and non - hepatic disease group. Laparoscope or laparotomy was used to collect liver tissue. The severity of collagen fiber deposition in liver perisinusoidal space was observed under transmission electron microscope(TEM). Results The collagen fi-ber deposition in liver perisinusoidal space presented in all the patients(20 / 20,100. 0% ). Of those cases, the percentage was 71. 4%(5 / 7)at the severe decompensation stage,33. 3%(3 / 9)at compensation stage and 25. 0%(1 / 4)at preclinical compensation stage. The cases of blood stagnation accounted for 55. 0%(11 /20)among the patients of liver cirrhosis,for 66. 6%(6 / 9)among the patients of severe collagen fiber deposi-tion and for 45. 4%(5 / 11)among the patients of mild deposition. Conclusion The collagen fiber deposition in liver perisinusoidal space is possibly getting worse in the progress of preclinical compensation,clinical compensation and decompensation stages. There is a certain correlation between the severity of collagen fiber deposition in liver perisinusoidal space and blood stagnation in TCM.