新甲型H1N1流感重症死亡病例呼吸道及外周免疫器官病理形态学及免疫细胞的变化

发布时间：2018-04-04 15:22

本文选题：新型甲型HN　切入点：尸检　出处：《首都医科大学学报》2015年05期

【摘要】：目的探索新型甲型H1N1流感病毒感染重症死亡病例呼吸道及外周免疫器官病理形态学及免疫细胞的变化。方法收集2009年北京甲型H1N1流感重症死亡病例8例,其中2例为系统尸体解剖标本,6例为床旁穿刺标本,以手足口病1例作为对照。HE染色观察病理形态学变化;免疫组织化学技术检测肺、脾和淋巴结免疫细胞变化。结果实验组表现为坏死性支气管炎和周围炎,弥漫性肺损伤、肺出血、纤维化,巨噬细胞明显增生,淋巴细胞浸润不明显。甲型H1N1流感病毒血凝素和核蛋白抗原主要表达于呼吸道上皮及巨噬细胞。免疫细胞计数:CD68+巨噬细胞显著增多,CD20+B淋巴细胞、CD3+、CD4+、CD8+T细胞减少,CD56+细胞偶见,各类细胞与对照组比较差异无统计学意义。脾和淋巴结病变基本一致,灶状组织细胞增生,"噬红现象"明显,淋巴组织萎缩,残留滤泡内以滤泡树突状细胞(follicular dendritic cell,FDC)细胞为主。免疫细胞计数:CD68+巨噬细胞显著增多,但与对照组比较差异无统计学意义(P0.05);CD20+B淋巴细胞、CD3+、CD4+、CD8+T免疫细胞数明显低于对照组(P0.05);CD4+和CD8+T淋巴细胞的比值与对照组相比,差异无统计学意义;CD56+细胞在脾脏明显低于对照组,淋巴结内两组均偶见。结论新型甲型H1N1流感重症患者外周免疫器官明显萎缩,特异性免疫功能减弱,其中细胞免疫反应下降更明显。
[Abstract]:Objective to investigate the changes of pathomorphology and immune cells in respiratory tract and peripheral immune organs of severe death cases infected with novel influenza A (H1N1) virus.Methods eight severe death cases of Beijing A H1N1 influenza in 2009 were collected. Among them, 2 cases were systemic cadaveric specimens and 6 cases were bedside puncture specimens. One case of hand, foot and mouth disease was used as control. He staining was used to observe the histopathologic changes.Immunohistochemical technique was used to detect the changes of immune cells in lung, spleen and lymph nodes.Results the experimental group showed necrotizing bronchitis and peripheral inflammation, diffuse lung injury, pulmonary hemorrhage, fibrosis, macrophage proliferation and lymphocyte infiltration.Hemagglutinin and nucleoprotein antigen of influenza A H1N1 virus are mainly expressed in respiratory epithelium and macrophage.The immunocyte count: CD68 macrophages increased significantly and CD20 B lymphocytes CD3 + CD3 + CD 4 + + CD8 T cells decreased occasionally, and there was no significant difference between the different types of cells and the control group.The pathological changes of spleen and lymph nodes were basically the same, the focal histiocytes proliferated, the "red phenomenon" was obvious, the lymphoid tissue shrank, and the follicular dendritic cells (follicular dendritic cell) cells were dominant in the residual follicles.CD56 cells in spleen were significantly lower than those in control group.Conclusion the peripheral immune organs and the specific immune function of severe patients with new type A H1N1 influenza are obviously shrinking, and the cellular immune response is more obvious.
【作者单位】：首都医科大学基础医学院病理学系;首都医科大学附属北京佑安医院;中国医学科学院北京协和医学院国家重点实验室阜外心血管病医院病理科;
【基金】：首都医学科技发展基金资助(2009-2091)~~
【分类号】：R511.7

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