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目的 探索Ⅲ型细胞死亡在重型肝炎中生物学特性和形态学特征及其发病中的意义。 方法用ICM-末端标记(ISEL)、ICM-DNA定量并结合形态学方法,观察17例重型肝炎中细胞死亡。 结果 ①Ⅲ型细胞的ISEL标记阳性,在急性和亚急性重型肝炎中的阳性率为(15±7)个/hpf,高于I型细胞的(5±3)个/hpr(P<0.05),而且无核周空晕,无凋亡小体形成,多分布于大片或亚大片坏死区和坏死边缘区,形态上与Ⅱ型细胞有过渡。②原位DNA定量I型、Ⅲ型细胞中亚2C细胞的百分率分别65％和46％,高于残存肝细胞的11％,(P<0.01～0.05),I型和Ⅱ型细胞中的亚2C分别为65％和29％,也存在差异(P<0.05);I型和Ⅲ型细胞核面积分别为22.09和25.11μm~2,均低于残存肝细胞的59.91μm~2(P<0.05)。③光镜下形态学观察表明:Ⅲ型细胞核染色质边聚,细胞体积缩小等有I型细胞特征,胞浆丰富,胞膜边界不清,又有Ⅱ型细胞特征。结论 Ⅲ型细胞死亡与凋亡和坏死相关,是在重型肝炎坏死区中出现的一种特殊类型的细胞死亡。
Objective To explore the biological characteristics and morphological characteristics of type Ⅲ cell death in severe hepatitis and its significance. Methods Cell death was observed in 17 cases of severe hepatitis by ICM-terminal labeling (ISEL) and ICM-DNA quantification combined with morphological methods. Results ① The positive ISEL markers of type Ⅲ cells were (15 ± 7) / hpf in acute and subacute severe hepatitis, (5 ± 3) / hpr (P <0.05) in type I cells, But also no nucleus week halo, no apoptotic body formation, and more in large or sub-large necrosis and necrotic marginal zone, morphology and type Ⅱ cells have a transition. In situ DNA quantification of type I and type III cells in the percentage of sub-2C cells were 65% and 46%, respectively, higher than 11% of the remaining hepatocytes (P <0.01 ~ 0.05), type I and type II cells (P <0.05). The area of type I and type III nuclei were 22.09 and 25.11μm 2, respectively, which were lower than 59.91μm ~ 2 (P <0.05) of remaining hepatocytes. . ③ Morphological observation under light microscopy showed that the type Ⅲ cell features such as edge clustering and shrinking of cell size in type Ⅲ nucleus, abundant cytoplasm, unclear membrane border and type Ⅱ cell characteristics. Conclusion Type III cell death is associated with apoptosis and necrosis and is a specific type of cell death in the area of severe hepatitis necrosis.