胆小管增生诱导胆道闭锁早期肝纤维化

目的观察门管区胆小管增生与肝纤维化的关系，进而探讨胆小管增生对胆道闭锁病程的作用和意义。方法选取在1997-2003年间经我科治疗的胆道闭锁(17例)和婴儿肝炎综合征(19例)患儿。术中肝活检标本石蜡切片行常规HE染色和免疫组化染色(Cytokeratin-7，Ki67)，观察手术时年龄、肝纤维化、胆管增生、胆管增生活性和术前直接胆红素水平。结果在胆道闭锁组，不同肝纤维化级别的胆小管增生级别有相关关系(rs=0．561，P=0．019)。结论大量的胆管迅速增生，诱导产生大量的基质沉积于门管区，可能就是胆道闭锁患儿肝纤维化迅速进展的主要原因。

Ductal proliferation induces liver fibrosis in the early stage of biliary atresia

Objective To evaluate the relationship between ductal proliferation and liver fibrosis. Methods Consecutive patients (17 biliary atresia,19 neonatal hepatitis) managed between 1997 to 2003 were reviewed. The liver biopsy specimens were examined by HE staining and immunostaining using cytokeratin-7 and Ki-67 antibodies. The follow-up duration, the liver fibrosis, ductal proliferation and the direct bilirubin were correlated. Results In biliary atresia, rank correlation was significant between ductal proliferation and liver fibrosis(r=(0.561),P=(0.019)).Conclusions Rapid ductal proliferation can induce massive stroma in portal area and possibly causes live fibrosis in biliary atresia.