77例不明原因肝功能异常患者的临床与病理特点

目的探讨不明原因肝功能异常患者的临床与病理特点。方法75例不明原因肝功能异常患者行1秒钟肝穿刺，2例外科手术肝活检，标本均送免疫组化双标记及HE染色、Masson染色、网状纤维染色、罗丹宁铜染色、普鲁士蓝染色，进一步分析其临床及病理特点。结果77例病因不明肝功能异常患者除6例无诊断学异常及3例非特异性炎症外，其余68例（88．31％）经肝组织病理检查分别诊断为急慢性肝炎12例、自身免疫性肝病27例、代谢性肝病4例、脂肪性肝病11例、药物性肝损伤10例、先天性肝纤维化及肝小静脉闭塞病各1例。结论肝组织病理检查在不明原因肝功能异常患者诊断价值较高，但由于病理检查存在一定的局限性，如果重视临床资料收集，通过临床及病理特点相结合的方法可进一步提高临床确诊率。

Clinical and pathological features of 77 cases of unexplained abnormal liver function

Objective To investigate the clinical and pathological features of unexplained abnormal liver function. Methods 75 cases of unexplained abnormal liver function underwent one-second liver biopsy and two cases under- went surgical biopsy. All the liver specimens were treated with double labeling immunohistochemistry, HE staining, Masson staining, reticular fiber staining, rhodanine copper staining, and Prussian Blue staining. The clinical and pathological features were further analysed. Results 68 cases （88.31%） had abnomal histopathology. Among them 12 cases were diagnosed as acute or chronic hepatitis, 27 cases of autoimmune liver disease, 4 cases of metabolic liver disease, 11 cases of fatty liver disease, 10 cases of drug-induced liver injury, 1 case of congenital hepatic fibrosis, and 1 case of hepatic veno-occlusive disease. Six cases had no diagnostic abnormalities and three cases of non-specific irdlammation. Conclusion Histopathological examination of liver has significant value in the diagnosis of unexplained liver function abnormalities, but with some limitations. Clinical diagnosis rate can be further improved by combining clinical and pathological features.