肝硬化病人胰臟變化之研究

因要明瞭肝硬化對胰臟的變化，選擇16例肝硬化病人，男12例，女4例為材料檢討胰臟組織學及細胞微細構造的變化。胰臟組織學的變化包括：異常纖維化有14例(87.5%)，其中４例(25%)為中度纖維化，10(62.5％)為輕度纖維化；外分泌組織中10例(62.5%)可見到胰腺細胞高度變小，腺腔擴大，分泌顆粒減少之導管細胞，這些集合一起形成導管複合體(tubular complex)。脂肪浸潤有8例(5%)，但多為輕度脂肪浸潤。胰小島(islet of Langerhans)有5例(31%) 發生玻璃變性(hyalinization)。電子顯微鏡觀察顥露了更精細的變化，幾乎所冈的內外分泌細胞都有變心；這些變化包括胰腺細胞自噬小胞的增加與變大，粗面內質網擴大及粒腺體腫脹，脂肪小滴的堆積及殘餘體增加。而組織學上所見的導管複合體，電子煩微鏡則顯示出除了酶原顆粒減少外，還存有豐富的粗面內質網等腺細胞的特徵。胰小島細胞尤其是B細胞顯露了粒腺體腫脹及細胞漿質擴大。以上光學及電子顥微鏡的觀察都揭露了肝硬化病人之胰臟內外分泌細胞的傷害或退行性變化。

關鍵字

無資料

並列摘要

This study was conducted on sixteen cirrhotic patients in an attemp to clarify the alterations of both endocrine and exocrine pancreas that occurs in this disease. The findings of Histological changes revealed that 14(87.5%)of the 16 patients had abnormal fibrosis in the exocrine pancreas, including 4cases (25%)having moderate fibrosis. Ten cases (62.5%)were found to have changes of the so called tubular complex which indicated degenerative changes of the exocrine pancreas. Hyalinization of the islet of Langerhans occurred in 5(31%) fo the 16 patients. In controls, only one (10%) of the 10 patients had mild fibrosis. (p＜0.01 Fisher’s exact test). The ultrastructural alterations are described as followings:An increase in size and number of autophagic vacuoles, dilation of rough endoplasmic reticulum and swollen mitochondria. Inclusion bodies of lipid droplets and residual bodies were also visible. An ultrastructural examination of the tubular complex revealed decreased heights of acinarcells with loss of zymogen granules and dilation of the acinar lumen. The changes also occurred in the islet cells especially in B cells, which evidenced widening cell sap and swollen mitochondria. By the findings of histological and ultrastructural examination, pancreatic injury or degenerative changes were revealed in the pancreas of cirrhotic patients.

並列關鍵字

liver cirrhosis ； pancreatic acinar cells ； islet of Langerhands

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肝硬化病人胰臟變化之研究

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