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目的：研究Ｆａｓ和Ｆａｓ配体（ＦａｓＬ）在乙型肝炎肝细胞凋亡及坏死中的作用。方法：分别用免疫组织化学方法和原位末端标记技术（ＴＵＮＥＬ试验）检测７１例各种类型乙型肝炎患者肝组织Ｆａｓ／ＦａｓＬ表达和肝细胞凋亡情况。结果：１．ＴＵＮＥＬ试验中度以上阳性，慢性迁延性肝炎（ＣＰＨ）为３１．６％（６／１９）、慢性活动性肝炎（ＣＡＨ）为１００％（２４／２４）、肝硬化（ＬＣ）为２２．２％（２／９）、重型肝炎（ＦＨ）为７８．９％（１５／１９）。２．Ｆａｓ表达中度以上阳性，ＣＰＨ为３６．８％（７／１９）、ＣＡＨ为９１．７％（２２／２４）、ＬＣ为５５．６％（５／９）、ＦＨ为７３．７％（１４／１９）。３．ＦａｓＬ表达中度以上阳性，ＣＰＨ为２１．１％（４／１９）、ＣＡＨ为７９．１％（１９／２４）、ＬＣ为５５．６％（５／９）、ＦＨ为９４．７％（１８／１９）。肝细胞凋亡及Ｆａｓ和ＦａｓＬ表达的阳性程度，在各型乙型肝炎中的分布均有显著性差异（Ｐ值＜０．００５）。部分病例肝细胞同时有Ｆａｓ和ＦａｓＬ表达。结论：Ｆａｓ和ＦａｓＬ在肝细胞凋亡和坏死中起重要作用，肝细胞的直接自杀方式或自分泌及旁分泌杀伤机制，可能为乙型病毒性肝炎发病机理的重要?
Objective: To investigate the role of Fas and Fas ligand (L-FasL) in hepatocyte apoptosis and necrosis in Hepatitis B patients. Methods: The expressions of Fas / FasL and hepatocyte apoptosis in liver tissue of 71 patients with various types of hepatitis B were detected by immunohistochemistry and TUNEL. Results: 1. TUNEL was moderately positive with 31.6% (6/19) of chronic persistent hepatitis (CP), 100% (24/24) of chronic active hepatitis (CA) and 22.2 of cirrhosis (LC) % (2/9) and severe hepatitis (FH) 78.9% (15/19). 2. The positive expression of Fas was 36.8% (7/19) in CPH, 91.7% (22/24) in CAH, 55.6% (5/9) in LC, 73.7% in FH 14/19). 3. The positive expression of FasL was moderate (21.1% (4/19) in CPH, 79.1% (19/24) in CAH, 55.6% (5/9) in LC and 94.7% in FH 18/19). The positive rate of hepatocyte apoptosis and Fas and FasL expression in each type of hepatitis B were significantly different (P value <0.005). Some cases of liver cells have both Fas and FasL expression. Conclusion: Fas and FasL play an important role in the apoptosis and necrosis of hepatocytes. The direct suicide mode of hepatocytes or the mechanism of autocrine and paracrine killing may play an important role in the pathogenesis of hepatitis B virus.