电镜观察从非典型肺炎患者尸检标本中发现衣原体样和冠状病毒样颗粒  

Chlamydia-like and coronavirus-like agents found in dead cases of atypical pneumonia by electron microscopy

作　　者：洪涛[1] 王健伟[1] 孙异临[2] 段淑敏[1] 陈良标[1] 屈建国[1] 倪安平[3] 梁国栋[1] 任丽丽[1] 杨仁全[1] 郭岚[1] 周为民[1] 陈杰[4] 李德新[1] 许文波[1] 徐红[1] 郭元吉[1] 戴淑玲[1] 毕胜利[1] 董小平[1] 阮力[1] 

机构地区：[1]中国疾病预防控制中心病毒病预防控制所,北京100052 [2]北京市神经外科研究所电镜室 [3]中国医学科学院中国协和医科大学北京协和医院检验科 [4]中国医学科学院中国协和医科大学北京协和医院病理科

出　　处：《中华医学杂志》2003年第8期632-636,共5页National Medical Journal of China

摘　　要：目的　探索 2 0 0 2年末暴发于广东等地的非典型肺炎的病原。方法　对来自广东、山西、四川省和北京市的 7例非典型肺炎死亡病人的尸体解剖标本进行超薄切片电镜观察 ,将病人肺组织提取物接种于 2 93细胞 (人胚肾转化细胞系 ) ,分离病原 ,对病人组织中和分离的病原进行免疫学鉴定。结果　超薄切片电镜观察 ,在死亡患者的肺 ( 7例 )、脾 ( 2例 )、肝 ( 2例 )、肾 ( 3例 )和淋巴结 ( 1例 )中均观察到衣原体样包涵体和网质小体、中间体、原生小体颗粒的存在 ,并在 3例病人肺组织中同时见到了冠状病毒样颗粒和未知的基质样结构。用RT PCR方法从 2例病人肺组织中扩增出冠状病毒RNA聚合酶基因片段。将病人肺组织提取物接种于 2 93细胞进行培养 ,取第 2代细胞作电镜观察 ,也发现衣原体样颗粒和包涵体的存在。在病人组织和培养细胞中见到的衣原体样颗粒均不能与衣原体属特异性抗体和抗肺炎衣原体、鹦鹉热衣原体抗体反应 ,提示可能为新的衣原体样因子。结论在死亡病人组织和培养细胞中发现的衣原体样和冠状病毒样颗粒 ,可能是广东等地暴发的非典型肺炎的主要病原。Objective To explore the causative agents of the atypical pneumonia ( also SARS) occurred recently in some regions of our country. Method Organ samples of 7 dead cases of SARS were collected from Guangdong, Shanxi, Sichuan Provinces and Beijing for electron microscopic examination. 293 cell line was inoculated with the materials derived from the lungs to isolate causative agent (s). The agents in the organs and cell cultures were revealed by immunoassay. Results Both Chlamydia-like and coronavirus-like particles were found in EM. Inclusion bodies containing elementary dodies, reticulate antibodies and intermediate bodies of Chlamydia-like agent were visualized in multiple organs from the 7 dead cases, including lungs(7 cases), spleens(2 cases), livers(2 cases), kidneys(3 cases) and lymph nodes(1 cases), by ultrathin section electron microscopy (EM). In some few sections, coronavirus-like particles were concurrently seen. A coronavirous RNA- polymerase segment (440 bp) was amplified from the lung tissues of two cases of the SARS. After inoculated with materials from the lung samples, the similar Chlamydia-like particles were also found in the inoculated 293 cells. Since the Chlamydia-like agents visualized in both organs and cell cultures could not react with the genus specific antibodies against Chlamydia and monoclonal antibodies against C. pneumoniae and C. psittaci, the results might well be suggestive of a novel Chlamydia-like agent. Conclusion Since the novel Chlamydia-like agent was found co-existing with a coronavirus-like agent in the dead cases of SARS, it looks most likely that both the agents play some roles in the diseas. At the present time, however, one can hardly determining how did these agents interact each other synergetically, or one follows another, need further study.

关 键 词：电镜观察 非典型肺炎 尸检标本 衣原体科 冠状病毒科 

分 类 号：R361[医药卫生—病理学]