越来越多的研究表明,慢性活动性肝炎的全身性损害与病毒有关。为研究慢性活动性肝炎全身性表现的形态学变化,作者检查活组织和尸解材料,包括外分泌腺(大、小涎腺、胃腺、肠腺、支气管腺、胰腺)、肾、皮肤和口腔粘膜血管,脾和淋巴结。大多数尸解病例均有明显的慢性活动性肝炎或活动性多小叶性肝硬变;肝细胞地衣红染色阳性;免疫组织化学检查不仅显示HBsAg,且有IgG、IgA和C_3,确证为病毒性肝炎和肝硬变。病人内部器官的形态学检查发现:外分泌腺播散性病变、纤维化性肺泡炎、肾小球肾炎和间质性肾炎、增生性和增生破坏性小脉管炎、淋巴结和脾浆细胞、巨噬细胞反应。这些内部器官的变化首先是由迟发型过敏反应引起,腺体及间质出现淋巴、巨噬细胞浸润和实质细胞萎缩死亡,随后结缔组织增生。免疫组织化学检查 More and more studies have shown that the systemic damage of chronic active hepatitis is related to the virus. To investigate the morphological changes of the systemic manifestations of chronic active hepatitis, the authors examined the biopsy and autopsy materials including the exocrine glands (large and small salivary glands, gastric glands, gut glands, bronchial glands, pancreas), kidneys, skin and oral mucosa Blood vessels, spleen and lymph nodes. Most of the autopsy cases had significant chronic active hepatitis or active multilocular cirrhosis; red staining of hepatocyte lichen was positive; immunohistochemistry not only showed HBsAg but also IgG, IgA and C_3, which were confirmed as viral Hepatitis and cirrhosis. Morphological examination of the internal organs of the patient revealed that the exocrine disseminated lesions, fibrotic alveolitis, glomerulonephritis and interstitial nephritis, proliferative and proliferative destructive vasculitis, lymph node and spleen plasma cells, giant Phagocyte reaction. Changes in these internal organs are primarily caused by delayed-type hypersensitivity reactions, lymphoid and macrophage infiltration of the glands and stroma, and atrophy of parenchymal cells followed by connective tissue hyperplasia. Immunohistochemistry