Abstract
The aim: to study some histopathological changes in the liver affected by steatohepatitis of various etiologies with the presence of anemia. Material and methods. Liver biopsies were analyzed in 30 patients with non-alcoholic steatohepatitis (NASH) and 20 patients with alcoholic steatohepatitis (ASH). The morphological examination of the liver was carried out according to the standard methods. The histopathological features of the liver were established on the basis of hematoxylin and eosin staining method, with confirmation, if necessary, by the histochemical methods - staining for fat (method with Sudan-III) and collagen fibers (method with chromotropic-water blue by NZ Slinchenko). Microspectrophotometric studies were performed using a cytological analyzer with software "VideoTest - Size 5.0" (2000). Results. A number of parameters revealed the statistical differences in the average trends with the use of the nonparametric Mann-Whitney method (p<0.05). The highest rate of hepatocyte necrosis was observed in the patients with ASH with anemia, in particular, more than a third of hepatocytes in these patients had signs of colic necrosis, which was more pronounced in ASH than in NASH. NASH with anemia was accompanied by more pronounced necrosis of hepatocytes than NASH without anemia. In ASH without anemia, the percentage of affected hepatocytes was on average approximately the same as in NASH without anemia. Fatty dystrophy of hepatocytes was observed in all the patients with NASH and ASH, but the severity of the general pathological process was not the same. Conclusions. Due to the comorbidity of fatty liver disease with anemia in both NASH and ASH, a much higher percentage of hepatocytes affected by reversible swelling are formed, which coincides with the tendency for hepatocyte oncosis. Anemia affects the nature of connective tissue growth in NASH and ASH (in ASH, the specific volume of connective tissue was higher than in NASH). At the same time, the intensity of regenerative processes in the liver (ductal reactions of the liver) is most pronounced in patients with anemia, and most - in ASH.
Highlights
Liver biopsies were analyzed in 30 patients with nonalcoholic steatohepatitis (NASH) and 20 patients with alcoholic steatohepatitis (ASH)
The highest rate of hepatocyte necrosis was observed in the patients with ASH with anemia, in particular, more than a third of hepatocytes in these patients had signs of colic necrosis, which was more pronounced in ASH than http://e-bmv.bsmu.edu.ua in NASH
NASH with anemia was accompanied by more pronounced necrosis of hepatocytes than NASH without anemia
Summary
Ключові слова: неалкогольний стеатогепатит, алкогольний стеатогепатит, анемія, гепатоцити, некроз. Проаналізовано біоптати печінки 30 хворих на неалкогольний стеатогепатит (НАСГ) та 20 хворих на алкогольний стеатогепатит (АСГ). Морфологічне дослідження печінки здійснювали за стандартною методикою. Некроз гепатоцитів був найбільше вираженим у хворих на АСГ з анемією, зокрема, понад третина гепатоцитів у цих пацієнтів мали ознаки колікваційного некрозу і був більш вираженим при АСГ, ніж при НАСГ. При АСГ без анемії відсоток уражених гепатоцитів був у середньому приблизно таким, як і при НАСГ без анемії. За коморбідності жирової хвороби печінки з анемією як при неалкогольному стеатогепатиті, так і при алкогольному стеатогепатиті формується значно вищий відсоток уражених оборотним набуханням гепатоцитів, що збігається з тенденціями за онкозом гепатоцитів. Інтенсивність регенераторних процесів у печінці (проточкові реакції печінки) найбільше виражені у пацієнтів із анемією, а максимально – при алкогольному стеатогепатиті.
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