肺源性心脏病患者的肝脏形态学研究附30例尸检病例分析

对30例肺心病尸检病例的肝脏形态学变化进行系统的观察,其病理改变表现为肝瘀血、脂肪变性、肝板解离和肝细胞坏死。4例死前有长达7 d 以上的持续性低氧血症的病例,肝脏发生了小叶中心性大片状肝细胞凝固性坏死,此病变与生前肝功能变化进行了对照分析。作者还发现肺心病病人心衰时间过长可发生肝硬化,其特点是:心衰史多在10 a 以上;肝硬化的形态特征是反常小叶形成。肺心病人虽也能发生肝硬化,但明显地低于其他类型的心脏病。

Morphological Studies of the Liver in Cor Pulmonale

The livers of 30 autopsies of cor pulmonale were observed morphorlogically.Hepatic congestion,fatty degeneration,atrophy of hepatic cells,detachment of hepatic plate and the focal necrosis of hepatic cells were the main features among the findings.An acute necrosis of the lobular central hepatic cells resulting from hypoxia appeared in four patients with serious hypoxemia lasting a week.The mechanism of this hepatic cell necrosis was discussed.The author conclude that the patient with cor pulmonale may suffer from cirrhosis,if the heart function is insufficient for a long time.This kind of cirrhosis has the following three charac- teristics:1.With a long history of heart failure,usually more than 10 years.2.Cirrhosis could follow cot pulmonale,but much less often than other kind of heart diseases. 3.And it is characterized by abnormal lobulation.