内科

目的探讨血清总胆汁酸（TBA）与慢性病毒性肝炎肝组织细胞成分变化的关系。方法对134例慢性病毒性肝炎患者做肝穿刺活检及检测血清TBA，应用病理图像分析仪以点计数法测量肝组织400倍镜视野内的主要细胞成分，测量内容包括良好肝细胞、变性肝细胞、纤维组织、脂肪细胞、淋巴细胞，计算各种组分的均数及密度。根据TBA水平的不同，将病人分成两组，比较两组病人之间五种肝组织细胞成分的差异，并使用多元线性逐步回归分析TBA升高者与肝组织细胞成分数密度的相关性。结果（1）TBA升高组较TBA正常组的肝组织中良好肝细胞显著减少，变性肝细胞、纤维组织、脂肪细胞、淋巴细胞显著增多，差异有统计学意义（P＜0.005）。（2）TBA与变性肝细胞、肝纤维化、淋巴细胞数密度成正相关，相关系数分别为0.433、0.367、0.494，与良好肝细胞、脂肪细胞无统计学相关。结论TBA升高与淋巴细胞数密度的相关性最密切，TBA升高可能具有间接或直接反映慢性病毒性肝炎患者肝组织的细胞免疫状态。

ObjectiveTo investigate the relationship between serum total bile acid(TBA) and the cell components of hepatic tissue in patients with chronic viral hepatitis.Method134 patients with chronic viral hepatitis were performed.The liver biopsy and serum total bile acid was tested at the same time.The liver tissue was measured by point-counting method using pathological image analysis instrument within the vision of 400 times microscope.The mean and the number contention of good liver cells,distortional liver cells,fibrous tissue,adipose cells and lymphocyte were calculated.The patients were divided into two groups according to the level of TBA.Five kinds of cells of liver tissue were compared in the two groups.The relationship between TBA and the number contention of the cells,components of hepatic tissue were investigated by multiple stepwise linear regression analysis.Results(1)The good liver cells were significantly lower in high-level TBA group than in low-level TBA group,but distortional liver cells,fibrous tissue and lymphocyte were increased significantly (P＜0.05).(2) There were positive correlation between TBA and distortional liver cells,fibrous tissue number contention of lymphocyte, the correlation coefficient was 0.433,0.367,0.494 respectively,but hadn′t statistic correlation with good liver cells and adipose cells.ConclusionThe rising of TBA has the closest relation with lymphocyte.It might reflect the immune status of patients with chronic viral hepatitis.