(精选)【医学课件课件】肝胆疾病的生物化学诊断 Biochemistry Diagnosis of Liver and Gallbladder教学课件.ppt

常见的病因包括： 病毒性肝炎(viral hepatitis) 酒精性肝炎(alcoholic hepatitis) 胆汁郁积(cholestasis) 严重心力衰竭（severe heart failure) 肝豆状核变性(hepatolenticular disease) ?-抗胰蛋白酶缺乏症（?- antitrypsin deficiency) 病 因 Aetiology 引起肝硬化的病因较多，同一病因可发展为不同病理类型的肝硬化，而同一病理类型的肝硬化亦可由不同病因引起。 1.肝硬化的生物化学机制 Cirrhosis of the biochemical mechanisms 缺氧和炎症刺激，导致胶原纤维合成增强。以I型及Ⅲ型为主。 Hypoxia and inflammatory stimulation, resulting in enhanced synthesis of collagen fibers. I type in the main-and Ⅲ. 机体免疫机能不足，肝细胞反复遭受HBV破坏，以及肝细胞结节状再生，纤维组织不断增生，导致肝硬化。 Lack of immune function, liver cells from recurring destruction of HBV, as well as nodular liver cell regeneration, continuous proliferation of fibrous tissue, leading to cirrhosis. 跟Kuffer细胞分泌多种细胞因子及胶原酶等生物活性物质以及储脂细胞产生胶原等有关。Kuffer cells with a variety of cytokines and bio-active substances, such as collagenase, as well as fat-storing cells produce collagen and so on. 涉及许多遗传因素，这已成为肝细胞对损伤反应的独立病原因素。肝细胞和胆管上皮细胞内角蛋白的表达异常等都与肝纤维化有关。Many of the genetic factors involved, this has become a liver cell injury in response to the independent pathogenic factors. 1.肝硬化的生物化学机制 Cirrhosis of the biochemical mechanisms Jaundice may result from: increased production of bilirubin impaired metabolism of bilirubin reduced bilirubin excretion combination of the above  2、黄疸的分类(classification) (1)病变部位 溶血性黄疸 （hemolytic jaundice） 肝细胞性黄疸 （hepatocellular jaundice） 阻塞性黄疸 （obstructive jaundice） 2、病因 肝前性黄疸 (prehepatic jaundice) 肝性黄疸 (hepatic jaundice) 肝后性黄疸 (posthepatic jaundice) 3、升高的胆红素类型 高未结合胆红素性黄疸 高结合胆红素黄疸 Over production of Bilirubin (Hemolytic) 各种原因引起红细胞破坏过多 未结合胆红素生成过多 超过肝细胞的结合和排泄能力 溶血性黄疸 A variety of causes excessive red blood cell damage generate too much unconjugated bilirubin excess the combination of ability and excretion of liver cells hemolytic jaundice. Impaired hepatic function (Hepatitic) 肝细胞对未结合胆红素的摄取、结合、排泄发生障碍 Hepatocellular dysf