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Clinical Characteristics And Pathology Features In 218 Acute And Chronic Liver Disease Patients Undergoing Liver Biopsy

Posted on:2017-04-24Degree:MasterType:Thesis
Country:ChinaCandidate:X X HeFull Text:PDF
GTID:2284330482489973Subject:Internal medicine
Abstract/Summary:PDF Full Text Request
Objective:To explore the value of liver histological examination in the diagnosis and therapy of the acute and chronic liver diseases.Methods:Data were collected and analyzed in two hundred and eighteen cases performed ultrasound/CT-guided percutaneous liver biopsy from May, 2012, to January, 2016 in China-Japan Union Hospital of Jilin University retrospectively.Results:1. Ultrasound guided percutaneous liver biopsy was performed successfully in two hundred and eighteen cases(100%).2. 218 patients who undergoing liver biopsy, 128 patients with chronic viral hepatitis, consisted of 110 patients with chronic hepatitis B and 18 patients with chronic hepatitis C; 37 patients with drug-induced liver injury; 23 patients with autoimmune liver disease; 17 patients with liver focal lesions; 4 patients with nonalcoholic fatty liver disease; 1 patient with alcoholic fatty liver disease; 40 patients with cholestatic liver disease; 5 patients with idiopathic portal hypertension; 5 patients with unknown explaination.3. 110 patients with chronic hepatitis B,48/98 patients underwent liver biopsy decided to start the antiviral treatment, 9 patients demonstrated liver cirrhosis, 3patients had poor antiviral treatment with distinguished hepatic steatosis.4. 37 patients with drug-induced liver injury, according to biochemical tests demonstrated 21 patients with liver cell injury, 7 patients with seven cases of cholestasis and mixed type in 9 cases, including the most common type of liver cell injury; according to pathological histological changes demonstrated 24 patients with acute and chronic hepatitis, 6 patients with cholestatic hepatitis, 5 patients with mixed hepatitis, 1 patient with idiopathic portal hypertension, 1 patient with vanishing bile duct syndrome, acute and chronic hepatitis was the most common type; according to the cause of drug-induced liver injury, traditional Chinese medicine was the most common durg.5. 23 patients with autoimmune liver diseases,consisted of 13 patients with PBC(11 patients with serum AMA-M2 antibody positive, 2 patients with serum AMA-M2 antibody negative), 4 patients with overlap syndrome(3 patients with AIH/PBC overlap syndrome, 1 patient with PBC/PSC overlap syndrome), 6 patients with PSC.According to histopathological staging of PBC, 2 patients with stage I, 6 patients with stage II, 1 patient with stage II-III, 1 patient with stage III, 3 patients with stage IV,including 3 patients with drug-induced liver injury simultaneously.6. 17 patients with liver focal lesions underwent liver biopsy demonstrated 10 patients with diagnosed with primary liver cancer(9 patients with hepatocellular cancer, 1 patient with cholangiocarcinoma), 4 patients with nodular hyperplasia, 2patients diagnosed as parasitic hepatic abscess, 1 patient diagnosed as inflammatory pseudotumor.7. 4 patients with nonalcoholic fatty liver disease underwent liver biopsy demonstrated 3 patients with simple fatty liver, 1 patient with non-alcoholic steatohepatitis.8. 40 patients with cholestatic liver disease through etiology analysis showed that13 patients with PBC, 6 patients with PSC, 7patients with drug-induced liver injury,1patient with sepsis, 1 patient with chronic viral hepatitis, 1 patient with bile ducts insufficiency obstruction. 10 patients with two or more causes, including 3 patients with AIH/PBC overlap syndrome, 1 patient with PBC/PSC overlap syndrome, 3patients with drug-induced liver injury combined PBC, 3 patients with drug-induced liver injury associated with chronic hepatitis B hepatitis, 1 patient with unknown etiology.9. 5 patients with idiopathic portal hypertension, 3 patients considered as drug-induced liver injury, one patient with intrahepatic arterial- portal fistula, 1patient with unknown etiology.Conclusion:1. The ultrasound-guided percutaneous liver biopsy which has high success rate,good safety and minimal side effects.2. Liver biopsy(LB) has become an important tool in the diagnosis,differential diagnosis in patients with clinically diagnosed liver disease, such as cholestasis liver disease, drug-induced liver injury, liver focal lesions, unexplained abnormal liver function and catching the best time for treatment.3. Liver biopsy used for the grade and diagnosis of chronic viral hepatitis,non-alcoholic fatty liver disease, autoimmune liver disease classification.4. Liver biopsy have the irreplaceable advantages and inevitable limitations. In order to improve the diagnostic accuracy, we need to comprehensively analyze the complete medical records, laboratory test result and pathology examination.
Keywords/Search Tags:Liver biopsy, Acute and chronic liver disease, Histological examination, Clinical features
PDF Full Text Request
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