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肝组织病理学检查在药物性肝损伤诊治中的意义

杨瑞园 赵新颜

引用本文:
Citation:

肝组织病理学检查在药物性肝损伤诊治中的意义

DOI: 10.3969/j.issn.1001-5256.2018.06.007
详细信息
  • 中图分类号: R575

Significance of liver histopathological examination in diagnosis and treatment of drug-induced liver injury

  • 摘要: 近年来药物性肝损伤(DILI)的发病率总体呈上升趋势,早期准确诊断及评估肝损伤程度是诊治过程中亟需解决的挑战。DILI病理形态特点是由肝小叶结构及代谢特点决定的,病理损伤模式基础是靶点损伤,即肝细胞、胆管上皮及血管内皮,这些决定了DILI区别于其他疾病的特殊性。尽管DILI病理特点多样,但具有主要病理损伤模式:急性肝炎型、慢性肝炎型、急性胆汁淤积型、慢性胆汁淤积型、胆汁淤积性肝炎型。DILI病理损伤程度决定了患者临床严重程度及预后,病理学观察有助于早期甄别药物导致的小胆管损伤及血管内皮损伤。DILI肝脏组织学特点与其他疾病有重叠,需与临床指标密切结合,从而更加客观、准确、及时诊断评估DILI。简要综述了DILI的病理形态特点、损伤模式,阐述了肝组织病理学检查在DILI诊治过程中的意义。

     

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  • 收稿日期:  2018-03-31
  • 出版日期:  2018-06-20
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