海水环境创伤弧菌感染的病理学研究  

Pathological study of Vibrio vulnificus infection in marine environment

作　　者：郑晶[1] 申洪[1] 陈清[2] 

机构地区：[1]南方医科大学病理学教研室,广州510515 [2]南方医科大学流行病学教研室,广州510515

出　　处：《中华创伤杂志》2007年第11期874-878,共5页Chinese Journal of Trauma

基　　金：广东省自然科学基金资助项目（4020381）

摘　　要：目的观察总结海水环境中感染创伤弧菌（vibrio vulnificus，Vv）后局部组织和器官的病理学特点，为临床Vv感染的诊治提供一定的实验依据。方法128只SPF级昆明小鼠，随机分成4组，每组32只，分别为海水Vv菌液浸泡组（A组）、等渗盐水Vv菌液浸泡组（B组）、单纯无菌海水浸泡组（c组）以及单纯无菌致伤组（D组）。每组又随机分成0，6，12，24h4个不同时间组，每组8只。D组小鼠仅无菌致伤，A、B、C组小鼠在无菌致伤后按分组设计均浸泡于相应液体中45～60min。于不同时段对各组局部肌组织及主要脏器组织进行取材、制片、HE染色和观察；采鼠尾血进行Vv的分离培养。结果A组创伤组织的损伤最为严重：0h时，可见肌纤维变性、溶解和断裂，但炎症反应不明显；12h时肌组织溶解坏死更加明显，肌间隙增宽，渗出及出血明显，并伴有大量中性粒细胞浸润；24h时，肌组织大片溶解坏死，微脓肿形成。总体来讲，Vv感染的A、B两组要比未感染的c、D两组病变严重，而组织修复过程也要缓慢。海水菌液浸泡组脱离浸泡后24h时仍无好转趋势，并且该组部分小鼠Vv血培养结果为阳性。Vv血培养阳性的小鼠其主要脏器也出现不同程度的损伤，以肺和肾脏的广泛出血性损伤为主。结论在海水环境中Vv经由皮肤伤口侵入后，其伤口往往表现为感染早、发展快且病变严重的特点。感染组织病理学特点为组织大片的溶解坏死和大量中性粒细胞浸润并伴有脓腔形成；Vv可经伤口人血，引发败血症，并导致小鼠肺、肾等多脏器的损伤。Objective To observe the pathological changes of regional tissues and organs after Vibrio vulnificus （Vv） infection in a marine environment so as to provide experimental and theoretical foundatiou for clinical therapy of Vv infectiou. Methods A total of 128 KM mice at grade of SPF were randomly and equally divided into four groups （with 32 mice in each group）, ie, Vv infection in marine environment group （Group A）, Vv infection in non-marine environment group （Group B）, wounded skin exposed to a marine environment with no Vv contact group （ Group C ） and only skin and muscle wound group （ Group D）. All Groups except for Group D were soaked for 45-60 minutes to establish corresponding animal model. Each group was equally divided into four subgroups, 0, 6, 12 and 24 hours groups. At different time points （0, 6, 12 and 24 hours）, regional muscular tissues and main viscera were collected under sterile condition for slicing and HE staining. And Vv from tail blood was also cultured separately. Results The most severe pathological changes of Vv infection were seen in Group A, with degeneration, lysis and breakage of myofibril but without obvious inflammatory reaction at 0 hour; with obvious lysis and necrosis of muscular tissues, widened spatium intermusculare, exsudatiou, hemorrhage and neutrophilic leukocyte infiltration at 12 hours; and with fargeing necrosis and abscess at 24 hours. In general, Groups A and B had more severe Vv infection and slower reparative process than Groups C and D. Group A showed no improvement after 24 hours of soaking and the results of Vv culture from blood of seven mice with Vv infection in were positive. In mice with positive culture of Vv blood, the lung and kidney were the main viscera suffering different degrees of injury. Conclusions Vv infection via the skin and muscle wound in a marine environment is characterized by early infection, rapid development and severe pathological changes. The main pathological characteristics are lysis and necrosis of fargoin

关 键 词：创伤和损伤 弧菌感染 病理学 人工海水 

分 类 号：R686[医药卫生—骨科学]