CAJ | 학술논문

目的分析婴儿巨细胞病毒(CMV)性肝炎的临床病理表现,以提高对该病的认识.方法 30例CMV性肝炎患儿临床资料分析并行肝穿刺活组织检查,光镜及电镜观察肝细胞的特征性改变.结果婴儿CMV肝炎的临床主要表现为黄疸、肝脾肿大及伴发症状、体征;实验室检查肝功能异常、CMV相关病毒检查阳性;影像学检查显示肝脏增大;肝穿刺活组织光镜观察显示肝细胞变性,坏死、纤维化、淤胆等一般性损伤,特征性改变为肝细胞内病毒包涵体、巨细胞样肝细胞形成和局部"假腺管"样排列,电镜观察找到病毒颗粒.结论 CMV DNA和抗体检查对于婴儿CMV性肝炎的诊断应用有限,疑似病例的肝穿刺活组织检查有助于明确CMV性肝炎的诊断.
목적 분석영인거세포병독(CMV)성간염적림상병리표현,이제고대해병적인식.방법 30례CMV성간염환인림상자료분석병행간천자활조직검사,광경급전경관찰간세포적특정성개변.결과 영인CMV간염적림상주요표현위황달、간비종대급반발증상、체정;실험실검사간공능이상、CMV상관병독검사양성;영상학검사현시간장증대;간천자활조직광경관찰현시간세포변성,배사、섬유화、어담등일반성손상,특정성개변위간세포내병독포함체、거세포양간세포형성화국부"가선관"양배렬,전경관찰조도병독과립.결론 CMV DNA화항체검사대우영인CMV성간염적진단응용유한,의사병례적간천자활조직검사유조우명학CMV성간염적진단.
Objective To investigate the clinicopathological features of infantile cytomegalovirus hepatitis.Method Liver biopsies from 30 cases of infantile cytomegalovirus hepatitis were observed under optical microscope and electronic microscope.Result The main clinical manifestations were jaundice,splenohepatomegaly and hypohepatia.Laboratory test showed dysfunction of liver,high level of CMV DNA,and high titer of anti-CMV antibody.Imaging examination demonstrated hepatomegaly.The histological changes were hepatocellular degeneration,necrosis,apoptosis,and fibrosis.The histological characteristics of cytomegalovirus hepatitis,including intranuclear inclusions in muitinucleated giant cells and pseudo-lumens,were also observed under optical microscope.In addition,virion was observed in the nuclei and cytoplasm of hepatocytes under electronic microscope.Conclusion The viral DNA and serological tests have limited utility for the diagnosis of infantile cytomegalovirus hepatitis,and the final diagnosis depends on histopathology.