第03课 陶小红-cirrhosis.ppt

CIRRHOSIS of LIVER Xiaohong Tao The First Affiliated Hospital Chongqing University of Medical Sciences Introduction 一种或几种病因长期或反复作用引起的慢性进行性肝病的后期阶段。(It’s the end result of hepatocellular injury resulted from different causes, ERLD ) 病理—有广泛肝细胞变性坏死、肝细胞结节性再生、结缔组织增生及纤维化，正常肝小叶结构破坏和假小叶形成、肝逐渐变形、变硬。The histologic feature is degeneration, regeneration(nodular) and fibrosis. According to the following sequence: INJURY DEGENERATION and necrosis regenerationFIBROSISFORMATION OF FIBRO-VASCULAR MEMBRANES PARENCHYMAL DISSECTION INTO NODULESREARRANGEMENT OF BLOOD CIRCULATIONCIRRHOSIS REARRANGEMENT OF BLOOD CIRCULATIONCIRRHOSIS Introduction 临床—肝功能损害和门脉高压为主、晚期常出现消化道出血、肝性脑病等并发症。(The clinical manifestations can be broadly classified into those resulting from hepatocellular dysfunction, such as jaundice and coagulopathy and portal hypertension. The complication often appear in late phase, such as hemmorrage, hepatic encephalopathy. 世界性疾病，所有种族、不论国籍、年龄或性别、均可罹患。 年龄35～48岁最多，男：女为3．6～8：1。 Cirrhosis is the third most common cause of death, after heart disease and cancer. killing about 25,000 people each year. HISTORY In 1761, This peculiar transformation of the liver was identified by the first anatomic pathologist, Gianbattista Morgagni in his 500 autopsies. HISTORY In 1826 (65years latter), the name of cirrhosis was given by Laennec because of the yellowish-tan color of the cirrhotic liver. cirrhosis (greek=orange color). HISTORY Only in 1930, one hundred years later, the first theory as to the pathogenesis of this disorder was advanced by Roessle: parenchymal degeneration, regeneration and scarring which is now understood according to the following sequence: HISTORY ETIOLOGY (CAUSES) ETIOLOGY 2.Alcohol abuse 14 3. Bile duct obstruction (PBC, PSC) 4. Exposure to certain chemicals Use of certain drugs (CCI4) 13 5.Persistent obstruction to outflow of blood from the liver (such as occurs in the Budd-Chiari syndrome) Heart and