肠道病毒71型感染并发神经源性肺水肿与神经细胞凋亡的关系  被引量:1

The correlation between Enterovirus-71 infection complicated with neurogenic pulmonary edema and nerve cell apoptosis

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作  者:钟涛[1] 郑伟华[1] 欧维琳[1] 李运千[2] 彭娟[1] 王长英[1] 李雄[1] 

机构地区:[1]桂林医学院附属医院儿科 [2]桂林医学院附属医院病理科,广西桂林541001

出  处:《广东医学》2015年第3期375-378,共4页Guangdong Medical Journal

基  金:国家自然科学基金资助项目(编号:81360248);广西医疗卫生重点科研课题(编号:重2012008)

摘  要:目的探讨肠道病毒71型(EV71)感染并发神经源性肺水肿与神经细胞凋亡的关系。方法收集9例EV71重症感染并发肺水肿死亡患儿(感染组)以及同期7例未感染EV71而出现肺水肿、肺出血等并发症死亡患儿(对照组)的临床资料,对患儿尸体系统解剖,对脑、心、肺进行原位末端脱氧核苷酸转移酶标记法检测凋亡细胞,光镜下观察。结果感染组各器官病理学检查可见脑组织有局部软化灶及卫星现象,肺组织可见肺泡腔塌陷,部分肺泡腔内充满水肿液,心肌组织均未见明显异常。对照组各器官脑组织及心肌组织未见异常,肺泡组织可见肺泡腔内存在粉红色均质水肿液。感染组各器官均检测到凋亡细胞,阳性检出率100%。感染组脑组织细胞凋亡明显,凋亡指数高,与感染组心肌组织和肺泡组织比较,差异均有统计学意义(P<0.01);感染组心肌组织及肺泡组织均可见少量凋亡细胞,凋亡指数较低,差异无统计学意义(P>0.05);对照组各器官均出现少量凋亡细胞,各器官间比较差异无统计学意义(P>0.05),与感染组相对应各器官进行比较,除脑组织差异有统计学意义(P<0.05)外,心、肺差异均无统计学意义(P>0.05)。结论 EV71重症感染并发肺水肿可引起大量神经细胞凋亡。Objective To investigate the correlation between enterovirus -71 (EV71) infection complicated with neurogenic pulmonary edema and nerve cell apoptosis .Methods The clinical data were retrospectively collected in 9 children dead of EV71 infection complicated with neurogenic pulmonary edema and 7 EV71 uninfected children dead of pulmonary edema or pulmonary venous pleonaemia from Mar , 2010 to Jun, 2013.Autopsy was performed.Tissue samples of major organs, including brains, lungs and hearts were tested by TUNEL method , and the morphological change of apop -tosis under light microscopy was also observed .Results Local soften foci and satellite phenomenon in brain , and visible alveolar cavity collapse and alveolar lumen filled with edema fluid in lung were observed in infection group .However, no pathological change was observed in myocardial tissues in infection group .Meanwhile, no pathological change in brain or myocardial tissues, but pink edema fluid in alveolar lumen was observed in control group .Apoptotic cells were detected in each organ in infection group , with positive rate of 100%.Significantly more prominent apoptosis was observed in brain tissues of infection group when comparing with myocardial or alveolar tissues (P 〈0.01).Several apoptotic cells were re-vealed in myocardial and alveolar tissues in infection group , with low apoptosis index (AI), and there was no significant differences between them (P &gt;0.05).Apoptotic cells in small count were observed in each organ in control group , with no significant difference among them .Significant difference was observed in only in apoptosis cell count between infection and control groups (P 〈0.05).Conclusion Severe EV71 infection complicated with pulmonary edema can cause cata -strophic nerve cell apoptosis.

关 键 词:肠道病毒71型 原位末端脱氧核苷酸转移酶标记 神经源性肺水肿 

分 类 号:R651.15[医药卫生—外科学]

 

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