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目的 确定严重急性呼吸系统综合征(SARS)病例尸解肺组织和咽嗽液中病原体种类。方法 用超薄切片电镜技术观察广东省传染性非典型肺炎流行早期3例死亡病例尸解肺组织标本,用RT- PCR法扩增尸解肺组织和SARS病人咽嗽液中SARS冠状病毒特异核酸片段,并进行序列测定。结果 在死亡病人肺组织中观察到衣原体的网状体、中间体以及原体颗粒,并见衣原体包涵体样结构;用RT- PCR法在2例尸解肺组织扩增出预期大小的DNA片段,测序后经相似性(BLAST)比较,其与SARS冠状病毒相应基因片段高度同源;用巢式RT -PCR技术在SARS病人咽漱液中扩增出SARS冠状病毒特异基因片段。结论 在SARS尸解肺组织中发现衣原体样颗粒,在尸解肺组织和咽漱液中扩增出SARS冠状病毒核酸片段,说明SARS患者可合并衣原体等微生物混合感染。
Objective To determine the types of pathogens in autopsy lung tissue and pharyngeal fluid from patients with severe acute respiratory syndrome (SARS). Methods Ultrathin section electron microscopy was used to observe the autopsy lung tissue specimens of 3 dead cases in the early stage of SARS epidemic in Guangdong Province. The SARS coronavirus specific nucleic acid in pharynx of SARS patients and autopsy lung tissues was amplified by RT-PCR Fragment, and sequence determination. Results Chlamydial reticulocytes, intermediates and proanthocyanidins were observed in the lungs of the deceased patients, and the inclusion bodies of chlamydia were observed. The DNA fragments of the expected size were amplified by RT-PCR in 2 cases of autopsy lung , Which was highly homologous to the corresponding gene fragment of SARS coronavirus by BLAST comparison after sequencing. The SARS coronavirus specific gene fragment was amplified by nested RT-PCR in pharyngeal swabs of SARS patients. Conclusion The SARS coronavirus nucleic acid fragment was amplified from autopsy lung tissue and pharyngeal swabs in SARS autopsy lung tissue, indicating that patients with SARS could be combined with mixed infection of chlamydia and other microorganisms.