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目的 :探讨SARS病理学特点及病原学与临床的关系。方法 :应用透射电镜、光镜、组织化学和免疫学方法对 2例 1～ 2周病程早期的SARS死亡尸检病例和 4例 3～ 5周病程中晚期的SARS死亡病例进行观察研究。结果 :电镜下冠状病毒样颗粒大小为 6 0～ 2 2 0nm ,呈多态性 ,还可见到衣原体样颗粒和疑似支原体样颗粒。SARS早期肺部病理改变为急性弥漫性肺泡损伤 ,肺水肿 ,广泛肺透明膜形成 ,脱屑性肺泡炎及小血管病变。SARS中晚期肺部病理改变以肺泡间质纤维增生和肺泡早期纤维化等机化性肺炎的表现为主要特征 ,同时有弥漫性肺泡损伤和脱屑性肺泡炎。结论 :不同病程的SARS有不同的病理学特征
Objective: To explore the pathological features of SARS and the relationship between etiology and clinical practice. Methods: The autopsy cases of 2 SARS deaths from 1 to 2 weeks and 4 death cases from 3 to 5 weeks of SARS were observed by transmission electron microscopy, light microscopy, histochemistry and immunology. Results: The size of coronavirus-like particles was 60 ~ 220 nm under electron microscopy, showing polymorphism. Chlamydia-like particles and suspected mycoplasma-like particles were also observed. The pathological changes of early lung in SARS are acute diffuse alveolar injury, pulmonary edema, extensive pulmonary hyaline membrane formation, desquamative alveolitis and small vessel lesions. Pulmonary pathological changes in advanced and middle-stage SARS are characterized by the manifestations of opportunistic pneumonitis such as alveolar interstitial fibrosis and early alveolar fibrosis, with diffuse alveolar damage and scaling alveolitis. Conclusion: Different pathological SARS have different pathological features