C.jejuni分离及周围神经不同状态病理变化

发布时间：2018-05-05 23:49

本文选题：空肠弯曲菌 + 吉兰-巴雷综合征　；参考：《河北医科大学》2012年硕士论文

【摘要】：第一部分GBS及非腹泻住院患者空肠弯曲菌携带情况研究目的：1、了解临床诊断的吉兰-巴雷综合征（Guillain-Barre syndrome,GBS）患者便标本空肠弯曲菌（Campylobacter jejuni, C.jejuni）携带情况；2、了解非腹泻住院患者便标本空肠弯曲菌携带情况。方法：1、标本采集：无菌棉签采集河北医科大学第二医院心血管内科、神经内科、消化内科、小儿内科、血液内科、内分泌科、皮肤性病科、腺体外科、胃肠外科、干部病房、呼吸内科11个科室的非腹泻住院患者的便标本，包括GBS患者，量约黄豆粒大小，放入盛有8mL布氏肉汤的西林瓶中，立即带回实验室；2、标本培养及细菌分离：将带回实验室的西林瓶立即置于42℃、微需氧环境（5%O2、10%CO2、85%N2）增菌培养，以24h为一周期，进一步应用分离平板传代，分离疑似空肠弯曲菌；3、鉴定方法：对分离得到的疑似空肠弯曲菌菌株，通过形态学、生化反应、分子鉴定等方法进行鉴定，确定为空肠弯曲菌后增菌保存；4、统计方法：统计标本来源的病例数和分离得到的阳性菌株数，对GBS患者及非腹泻住院患者分别统计便标本空肠弯曲菌携带阳性率。结果：1、8例临床诊断的吉兰巴-雷综合征患者便标本培养、分离空肠弯曲菌，，通过鉴定得到1株目的菌株；2、274例非腹泻住院患者便标本培养、分离，未见阳性空肠弯曲菌分出。结论：1、本实验对河北医科大学第二医院收住的临床诊断为GBS的8名患者的便标本进行空肠弯曲菌的培养分离，得到1株目的菌株，但对其与吉兰-巴雷综合症之间的关系及其致病性有待进一步研究；2、其他非腹泻住院患者的便标本未见可疑空肠弯曲菌分出，可能由于细菌状态、技术方法等方面的限制，出现假阴性结果，故本方法不合适该人群的空肠弯曲菌分离。第二部分周围神经沃勒变性病理观察及死亡后病理变化目的：1、认识周围神经沃勒变性（Wallerian degeneration）病理变化过程；2、鉴别死亡后周围神经病理变化，以区别动物模型疾病本身导致的病变和死亡后随时间延长自然病理变化。方法：1、建立沃勒变性动物模型，分别于神经切断后1h、2h、4h、6h、8h、12h、24h、2d、4d、6h、8d、15d行坐骨神经取材，远端神经同部位进行饿酸染色，光镜下观察病理变化；2、分别于小鼠活体及处死后1h、2h、4h、6h、8h、12h、24h、48h取材坐骨神经，行饿酸染色，观察病理变化。结果：1、神经切断后1h，远端神经可出现髓鞘不光滑，随时间延长，髓鞘逐渐回缩，2d时卵圆体形成，出现典型病变；2、周围神经随死亡时间的病理变化：小鼠处死后4h，坐骨神经行饿酸染色病理所见基本正常，6h出现病理性人为损伤，如牵拉损伤，随时间延长人为损伤增多，逐渐出现不规则破坏、虫蚀样等改变。结论：探讨周围神经沃勒变性和随死亡时间的病理变化，应用饿酸染色技术可动态观察其变化过程，可区分二者的典型病变。
[Abstract]:The first part is about the carriage of Campylobacter jejuni in GBS and non diarrhoea inpatients.
Objective: 1, to understand the carrying status of Guillain-Barre syndrome (GBS) and Campylobacter jejuni (C.jejuni) in the clinical diagnosis of Gillain Barre syndrome (GBS). 2, to understand the carrying situation of Campylobacter jejuni in non diarrhea inpatients.
Methods: 1, specimen collection: aseptic cotton swabs collected from the cardiovascular department of the second hospital of Hebei Medical University, neurology, digestive medicine, pediatric internal medicine, hematology, Department of Endocrinology, dermatology, gland surgery, gastrointestinal surgery, cadre ward, respiratory medicine 11 departments of non diarrhoea inpatients, including GBS patients and soya bean The size was put into the Silin bottle with 8mL broth soup and brought back to the laboratory immediately; 2, specimen culture and bacterial isolation: the Silin bottle was brought back to the laboratory at 42, the microaerobic environment (5%O2,10%CO2,85%N2) was cultured, and 24h was used as a cycle to separate the suspected Campylobacter jejunum by separating the flat plate, and 3. Methods: the isolated strains of Campylobacter jejuni were identified by morphology, biochemical reaction, molecular identification and other methods. The bacteria were identified for Campylobacter jejuni, and 4. Statistical methods: statistical methods: the number of cases and the number of positive bacteria isolated from the samples were statistically analyzed, and the samples were empty for GBS patients and non diarrhea inpatients. The positive rate of Campylobacter enteric was carried.
Results: 1 cases of gillalba ray syndrome were cultured in 1,8 cases, and Campylobacter jejuni was isolated. By identification, 1 strains were obtained. 2274 cases of non diarrhea hospitalized patients were cultured, separated and no positive strains of Campylobacter jejuni were found.
Conclusion: 1, in this experiment, the specimens of 8 patients diagnosed with GBS in the second hospital of Hebei Medical University were isolated and isolated from the culture of Campylobacter jejuni, and 1 target strains were obtained, but the relationship between them and Gillain Barre syndrome and its pathogenicity need to be further studied. 2, other non diarrhea hospitalized patients have no specimens. It is not suitable for the isolation of Campylobacter jejuni in the population because of the possibility of false negative results due to the limitation of bacterial state and technical methods.
The second part is peripheral nerve Waller degeneration pathology observation and pathological change after death.
Objective: 1, to recognize the pathological changes of peripheral nerve Waller denaturation (Wallerian degeneration). 2, to identify the pathological changes of peripheral nerve after death in order to distinguish the pathological changes caused by animal model disease itself and to prolong the natural pathological changes with time.
Methods: 1, the animal model of Waller denaturation was established. After the nerve was cut off, 1H, 2h, 4h, 6h, 8h, 12h, 24h, 2D, 4D, 6h, 8D, 15d line sciatic nerve, the distal nerve was stained with starving acid and observed pathological changes under light microscope; 2. Pathological changes.
Results: 1, after 1h, the myelin sheath was unsmooth in the distal nerve, and the myelin sheath was gradually retracted with time, the formation of the myelin sheath was gradually retracted, and the typical lesions were formed when 2D was formed. 2, the peripheral nerve was pathological changes with the death time: the mice were killed after the death of 4h, the sciatic nerve was basically normal, and the 6h appeared pathological artificial injury, such as traction. With the extension of time, artificial damage increased, and irregular damage and insect erosion changed gradually.
Conclusion: To investigate the pathological changes of the peripheral nerve Waller degeneration and the time of death, the change process can be observed dynamically by the technique of starving acid staining, which can distinguish the typical lesions of the two.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R745;R363

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