关键词: 胆道闭锁, 胆管炎, 肝移植, 抗原, CD4, 抗原, CD8, CD68, Kasai术

Abstract: Objective　To explore the relationship between the expressions of T lymphocyte surface antigens (CD4 and CD8)，macrophage-specific antigen (CD68) and Kasai postoperative cholangitis. Methods　Twenty-seven children with biliary atresia who underwent liver transplantation after Kasai operation were divided into frequent cholangitis group (10 cases), early cholangitis group (7 cases) and non-cholangitis group (10 cases) according to the previous outbreak of cholangitis. The general clinical data were compared between groups. The hilar liver tissues of each group were stained with HE to observe the degree of liver fibrosis, bile duct hyperplasia, inflammatory cell infiltration and bile plug. Immunohistochemical staining was used to detect the expressions of CD4, CD8 and CD68 proteins. Results　There were no significant differences in sex, age, age of Kasai operation, native liver survival rate, white blood cells, C-reactive protein and liver function before liver transplantation between the three groups. HE staining showed that there were no significant differences in liver fibrosis, biliary duct hyperplasia and bile plug between the three groups. But inflammatory cell infiltration was more serious in the confluent area of the frequent cholangitis group than that in the non-cholangitis group and the early cholangitis group. Immunohistochemical staining showed that no significant difference in CD4 protein expression between the three groups. The expressions of CD8 and CD68 proteins were significantly higher in frequent cholangitis group than those in the non-cholangitis group and the early cholangitis group (P＜0.05). Conclusion　The main pathological changes of hepatic cholangitis after Kasai operation are inflammatory cell infiltration in portal area, which are an inflammatory reaction involving CD8+ T cells and CD68+ macrophages. The increased expressions of CD8 and CD68 may be the risk factors of the recurrence of cholangitis.

Key words: biliary atresia, cholangitis, liver transplantation, antigens, CD4, antigens, CD8, CD68, Kasai operation