THROMBOSIS AND INTIMAL THICKENING IN THE PORTAL SYSTEM IN CIRRHOSIS OF THE LIVER.
THROMBOSIS AND INTIMAL THICKENING IN THE PORTAL SYSTEM IN CIRRHOSIS OF THE LIVER.
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肝硬化门脉系统血栓形成和内膜增厚。
DOI：
10.1002/path.1700890204
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发表时间：
1965
期刊：
影响因子：
--
通讯作者：
A. J. S. McFadzean
中科院分区：
文献类型：
--
作者：
Hou Pao Chang (P. C. Hou);A. J. S. McFadzean
64例（51%）静脉内皮表面检查发现宏观病变。坏死后肝硬化126例，脾肿大4例。三种可见病变为出血、附壁血栓和内膜增厚斑块。这些病变在门静脉、脾静脉和上级肠系膜静脉内的发生频率和分布见表。应该注意的是，当病变发生在上级肠系膜静脉时，病变仅限于远端2 cm，在静脉流动的线路上，在那条静脉的附近，从来没有遇到过。此外，肠系膜上上级静脉的内膜斑块也累及门静脉或脾静脉，除一个例外（图1）外，壁血栓是从门静脉或脾静脉延伸出来的（图2）。出血表现为黑点，出现在正常静脉或静脉节段，或更常见的是内膜增厚斑块。在前一种情况下，它们的大小从针尖到直径为1-3毫米的区域不等（图1和图2）。1和2），而在后者，他们往往更大。在手持镜头放大下，它们的轮廓清晰，在较大出血的情况下，不规则。同样，在手透镜下，在许多出血点周围的不规则区域，内皮细胞的正常光泽消失，似乎被颗粒状物质覆盖。壁血栓的大小变化很大，从几分钟到几厘米不等（图1和2）。2和4），任何一种制剂中的数量范围为1至5。他们最常遇到的准备工作显示，
RESULTSMacroscopic lesions were found on examination of the endothelial surface of the veins in 64 (51 per cent.) of the 126 cases of post-necrotic cirrhosis of the liver, and in all 4 cases of gross splenomegaly. The three visible lesions were haemorrhages, mural thrombi and plaques of intimal thickening. The frequency of occurrence and distribution of these lesions within the portal, splenic and superior mesenteric veins are given in the table. It should be noted that when lesions occurred in the superior mesenteric vein they were restricted to the distal 2 cm., in the line of venous flow, of that vein and were never encountered proximal to this. Further, each intimal plaque in the superior mesenteric vein involved also the portal or splenic veins, and mural thrombi, with one exception (fig. l), were seen to be extensions from one of the latter veins (fig. 2).Haemorrhages appeared as dark spots either in an otherwise normal vein or vein segment or, more commonly, in a plaque of intimal thickening. In the former situation they ranged in size from pin-point to areas 1-3 mm. in diameter (figs. 1 and 2) whereas in the latter they tended to be larger. At hand-lens magnification their outlines were sharply defined and, in the case of the larger haemorrhages, irregular. Again under a hand lens over and, in an irregular area, around many of the haemorrhages the normal glister of the endothelium was lost and it appeared to be covered with a granular material. Mural thrombi varied greatly in size from minute to a few centimetres (figs. 2 and 4) and the number in any one preparation ranged from 1 to 5. They were most commonly encountered in preparations showing