肾综合症出血热肾组织中病毒感染及病毒抗原的来源和意义  

Virus antigens in the renal tissues of patients with hemorrhagic feverwith renal syndrome and its correlation with virus infection andpathogenesis in the disease

作　　者：杨守京[1] 刘彦仿[1] 胡锡祺 李明升[1] 胡明华[1] 

机构地区：[1]上海医科大学病理学教研室,江西医学院病理学教研室

出　　处：《第四军医大学学报》1995年第6期401-408,共8页Journal of the Fourth Military Medical University

基　　金：国家自然科学基金

摘　　要：目的：明确肾综合征出血热（ＨＦＲＳ）肾组织中病毒感染及抗原的来源和意义。方法：应用免疫组化和原位分子杂交技术，分别对西安、沈阳、上海、江西和广州地区收集的３０例ＨＦＲＳ尸检肾组织进行了研究；结果：２８例进行病毒抗原检测，有２６例阳性（２６／２８／３０）；２８例进行病毒ＲＮＡ检测，２６例阳性（２６／２８／３０）。西安及沈阳病例，病毒抗原和ＲＮＡ阳性部位主要是肾小管上皮细胞。上海及江西病例，病毒抗原定位于肾间质血管内皮，血管壁和肾小管上皮；而病毒ＲＮＡ主要定位于肾间质血管和血管内皮，少数病例伴肾小管上皮细胞阳性；１例上海病例肾小管上皮细胞胞核病毒ＲＮＡ阳性。广州病例，病毒抗原主要定位于肾血管平滑肌细胞；在３例西安病例和６例上海病例肾脏远曲小管和集合管上皮细胞中检测到ＮＰ和ＨＡ抗原阳性的胞浆内病毒包涵体（ＣＩＢ）。在病变严重的肾小管和间质血管部位可同时检测到ＩｇＧ，ＩｇＭ和Ｃ３阳性；少数病例肾小球也有不连续阳性，但较前两者弱。结论：ＨＦＲＳ病毒可感染肾脏中肾小管上皮和血管内皮，并在肾小管上皮细胞产生包涵体，不同地区病例肾脏中病毒感染的部位不同，可能与不同地区病例所感染的病毒毒株或血清型不同有关。病毒感染所诱发的Ⅱ?Objective:To determine virus infection in the renal tissues of the patients with hemorrhagic feverwith renal syndrome(HFRS)and the role of viral antigens in the pathogenesis of the disease.Methods:Theviral antigens,IgG,IgM,C3 complement and RNA were detected by immunohistochemistry and in situ hy-bridization in the sequential tissue section. Thirty autopsy renal tissues were used for the study and they werecollected from Xi’ an,Shenyang,Jiangxi,Shanghai and Guangzhou endemic foci.Results:The viral antigenand RNA detection were performed on 28 of 30 cases separately and positive in 26 cases respectively.In thetissues of the cases from Xi’an and Shenyang,viral antigens and RNA were mainly localized in the cytoplasmand distributed in the renal tubular cells. In the tissues of the cases from Jiangxi and Shanghai,viral antigenswere localized in the vascular endothelial cells and tubular cells, while virus RNA mainly localized in the vas-culatures and vascular endothelial cells, in some cases together with tubular cells positive. In Guangzhou cas-es viral antigens were in smooth muscles of blood vessels and RNA in vasculatures. In 8 cases including 2 cas-es from Xi’an and 6 cases from Shanghai,cytoplasmic inclusion body was detected in the distal convolutedand collecting tubular cells, which was positive for viral NP and HA antigens. The proximal convoluted tubu-lar cells and interstitial vasculatures positive for viral antigens with or without RNA usually exhibited obviousmorphological alternation when the IGg,and/or IgM,and C3 complements were simultaneously detected.Conclusion:These findings indicated that the virus could infect both the tubular cell and vascular endothelialcell and could produce CIB in renal tubular cell.The variance of susceptible target cells in the tissues of thecases from different HFRS ende

关 键 词：肾综合征出血热 病毒 抗原 肾脏 免疫组织化学 

分 类 号：R512.8[医药卫生—内科学] R373.32[医药卫生—临床医学]