PATHOHISTOLOGICAL PECULIARITIES OF THE FORMATION OF IRON OVERLOAD SYNDROME IN PATIENTS WITH STEATOHEPATITIS DEPENDING ON ITS ETIOLOGY

T. Antofiichuk, I. Davydenko, O. Khukhlina, N. P. Antofiichuk, V. S. Haidychuk
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Abstract

The aim – to study some histopathological features of the iron overload syndromeformation in patients suffering from steatohepatitis depending on its etiology.Material and methods. Liver biopsies were analyzed in 30 patients with nonalcoholicsteatohepatitis (NASH) and 20 patients with alcoholic steatohepatitis (ASH). Themorphological examination of the liver was carried out according to the standardmethods. The histopathological features of the liver were established on the basis ofthe method of staining with hematoxylin and eosin, with the confirmation, in case ofnecessity, by the histochemical methods - staining for fat (the method with Sudan-III) andcollagen fibers (the method with chromotropic-water blue according to N.Z Slinchenko).Microspectrophotometric studies were conducted using a cytological analyzer withsoftware "VideoTest - Size 5.0" (2000).Results. The same regularities for both trivalent iron and twovalent iron were revealed asa whole in the liver cells at histological investigations, that is in ASH the optical densityis at the average 1.3 (p<0.05) times higher than in NASH. The staining on trivalent ironis less intensive, than on the twovalent iron. There is probable iron overload syndrome inthe alcoholic steatohepatitis patients with increased uptake of it both 2+- and 3+- valentforms in the liver cells – reticuloendotheliocytes and hepatocytesConclusions. Iron overload syndrome with increased uptake of it for both 2+- and3+-valent takes place in the liver cells – endotheliocytes and hepatocytes – in patientswith alcoholic steatohepatitis. At alcoholic steatohepatitis the optical density withhistochemical staining on iron 2+ in reticuloendotheliocytes of the liver is 1.2 times andin hepatocytes – 1.3 times higher than at non-alcoholic steatohepatitis irrespective ofthe presence or absence of anemia. At alcoholic steatohepatitis the optical density ofhistochemical iron staining 3+ in reticuloendotheliocytes of the liver and hepatocytesis 1.3 times higher than in non-alcoholic steatohepatitis, and is irrespective of anemiapresence as well.
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脂肪性肝炎患者铁超载综合征形成的病理组织学特点取决于其病因
目的:探讨脂肪性肝炎患者铁超载综合征在病因上的组织病理学特征。材料和方法。分析了30例非酒精性脂肪性肝炎(NASH)和20例酒精性脂肪性肝炎(ASH)患者的肝脏活检。肝脏形态学检查按标准方法进行。肝脏的组织病理学特征是在苏木精和伊红染色方法的基础上建立的,在必要的情况下,通过组织化学方法进行确认-脂肪染色(苏丹- iii方法)和胶原纤维染色(根据N.Z Slinchenko,用显色水蓝方法)。显微分光光度法研究使用细胞学分析仪软件“VideoTest - Size 5.0”(2000)进行。三价铁和二价铁在肝细胞整体上的组织学检查具有相同的规律,即ASH的光密度平均为NASH的1.3倍(p<0.05)。三价铁的染色强度不如二价铁。酒精性脂肪性肝炎患者可能存在铁超载综合征,肝细胞(网状内皮细胞和肝细胞)中2+-和3+-型铁摄取增加。酒精性脂肪性肝炎患者的肝细胞(内皮细胞和肝细胞)对2+价和3+价铁的摄取增加,出现铁超载综合征。在酒精性脂肪性肝炎中,肝脏网状内皮细胞的铁2+组织化学染色的光密度是非酒精性脂肪性肝炎的1.2倍,而在肝细胞中,铁2+组织化学染色比非酒精性脂肪性肝炎高1.3倍,无论是否存在贫血。在酒精性脂肪性肝炎中,肝脏网状内皮细胞和肝细胞增生的组织化学铁染色3+的光密度比非酒精性脂肪性肝炎高1.3倍,并且与有无贫血无关。
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