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Liver histology in ICU patients dying from sepsis:A clinico-pathological study

World Journal of Gastroenterology 2008年第9期14卷 1389-1393页

作者： John Koskinas Ilias P Gomatos Dina G Tiniakos nikolaos memos Maria Boutsikou Aspasia Garatzioti Athanasios Archimandritis Alexander Betrosian 2nd Department of Internal Medicine Athens Medical SchoolAthens 11527Greece Laboratory of Surgical Research 1st Department of Propaedeutic SurgeryAthens Medical SchoolAthens 11527Greece Laboratory of Histology and Embryology Athens Medical School Athens 11527Greece Laboratory of Surgical Research 1st Department of Propaedeutic Surgery Athens Medical School Athens 11527Greece Intensive Care Unit Hippocration HospitalAthens 11527Greece

AIM:To determine end-stage pathologic changes in the liver of septic patients dying in the intensive care unit. METHODS: Needle liver biopsies obtained immediately after death from 15 consecutive patients with sepsis and no underlying liver disease were subjected to routine histological examination. Liver function tests and clinical monitoring measurements were also recorded. RESULTS: Liver biochemistries were increased in the majority of patients before death. Histology of liver bi- opsy specimens showed portal inflammation in 73.3%, centrilobular necrosis in 80%, lobular inflammation in 66.7%, hepatocellular apoptosis in 66.6% and cholan- gitis/cholangiolitis in 20% of patients. Mixed hepatitic/ cholestatic type of liver injury was observed in 6/15 (40%) patients and hepatitc in 9/15 (60%). Steatosis was ob- served in 11/15 (73.3%) patients affecting 5%-80% of liver parenchyma. Among the histological features, the presence of portal inflammation in liver biopsy was as- sociated with increased hospitalization in the ICU prior death (P = 0.026). CONCLUSION: Features of hepatitis and steatosis arethe main histological findings in the liver in the majority of patients dying from sepsis.

关键词：败血症肝脏组织学活组织切片检查临床研究

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