自身免疫性肝炎诊治——病理必不可缺

王丽; 杨永峰

doi:10.3969/j.issn.1001-5256.2023.03.004

自身免疫性肝炎诊治——病理必不可缺

DOI: 10.3969/j.issn.1001-5256.2023.03.004

王丽¹,
杨永峰^2, , ,

1.
南京中医药大学，南京 210029
2.
南京中医药大学附属南京医院(南京市第二医院) 肝病科，南京 210029

基金项目:

国家自然科学基金 (81970454)

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明：王丽负责检索文献，撰写文章；杨永峰负责设计文章框架，文献检索策略，修改和审核文章。

详细信息

通信作者:
杨永峰，yyf1997@163.com(ORCID: 0000-0002-3214-0038)

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出版历程
- 收稿日期: 2022-12-31
- 录用日期: 2023-02-07
- 出版日期: 2023-03-20

Diagnosis and treatment of autoimmune hepatitis: The indispensable role of pathology

Li WANG¹,
Yongfeng YANG^{2
, ,
,}

1.
Nanjing University of Chinese Medicine, Nanjing 210029, China
2.
Department of Hepatology, Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine & Nanjing Second Hospital, Nanjing 210029, China

Research funding:

National Natural Science Foundation of China (81970454)

More Information

Corresponding author: YANG Yongfeng, yyf1997@163.com (ORCID: 0000-0002-3214-0038)

摘要

摘要: 自身免疫性肝炎现已成为国内主要的非感染性肝炎类型，本文从临床及病理角度归纳并论述了其特征性表现及诊治现状，总结出病理组织学在自身免疫性肝炎诊治中必不可缺的地位。
- 肝炎, 自身免疫性 /
- 病理学, 临床 /
- 诊断
Abstract: Autoimmune hepatitis has become the main type of non-infectious hepatitis in China. This article summarizes its characteristic manifestations and the current status of diagnosis and treatment and points out that pathological histology plays an indispensable role in the diagnosis and treatment of autoimmune hepatitis.
- Hepatitis, Autoimmune /
- Pathology, Clinical /
- Diagnosis

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图 1 慢性发病AIH病理特征(HE染色)

注：a, 界面性肝炎(×10)；b, 浆细胞浸润，箭头示浆细胞(×40)；c, 玫瑰花结(×40)；d, 箭头示淋巴细胞穿入(×40)。

Figure 1. Pathological characteristics of chronic AIH (HE staining)

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表 1 依据小叶及汇管区炎症表现的AIH诊断标准

Table 1. Histological criteria of AIH based on lobular and portal inflammation

项目	汇管区炎	小叶炎
极可能的AIH	汇管区淋巴-浆细胞浸润+以下1种或2种特征: (1)轻度以上界面炎; (2)轻度以上小叶炎排除提示其他肝病的组织学特征	轻度以上小叶炎(伴或不伴小叶中心性坏死)+以下至少1种特征: (1)淋巴-浆细胞浸润; (2)界面炎; (3)汇管区纤维化排除提示其他肝病的组织学特征
可能的AIH	汇管区淋巴-浆细胞浸润 ·不具有上述1种或2种极可能的特征之一 ·排除提示其他肝病的组织学特征或 ·具有上述1种或2种极可能的特征 ·存在提示其他肝病的组织学特征	任何小叶炎(伴或不伴小叶中心性坏死) ·不具有上述1~3种极可能的特征之一 ·排除提示其他肝病的组织学特征或 ·具有上述任何1种极可能的特征 ·存在提示其他肝病的组织学特征
不可能的AIH	汇管区炎 ·不具有上述1种或2种极可能的特征之一 ·存在提示其他肝病的组织学特征	小叶型肝炎 ·不具有上述任何极可能的特征 ·存在提示其他肝病的组织学特征

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