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严重急性呼吸综合征(severe actue respiratory syndrome,SARS),我国暂命名为急性传染性非典型肺炎(acuteinfectionus atypieal pneumonia,AIAP),简称非典型肺炎(AP)是近几个月流行全球30余个国家和地区的一种急性传染病,该病来势凶险,传染性极强,是目前国际医学界研究的焦点,本文作者根据4例系统尸体解剖和2例会诊资料对SARS的病理学特点及其发病机制作简要概述。本研究发现SARS的病理变化主要包括肺部病变,免疫器官损伤,全身小静脉炎,全身中毒性改变和继发感染4个方面。肺部病变主要包括肺水肿、肺泡上皮增生、融合、脱落、凋亡是脱屑性肺炎变化,局灶性出血坏死,局灶性肾小球状机化性肺炎,大量肺透明膜形成,肺泡上皮内可见病毒包涵体及病毒性颗粒;免疫器官损伤,脾脏淋巴组织大片状坏死,淋巴结灶性坏死;全身小静脉炎;全身多器官内小静脉周围及血管壁水肿,灶性纤维素样坏死,单核细胞及淋巴细胞浸润,部分小静脉内有血栓形成;全身中毒性变化和继发感染;全身多器官实质细胞变性坏死和继发霉菌感染。肺和免疫器官是SARS病毒攻击的主要靶器官。SARS的发病机制不清,可能与SARS病毒进入机体后通过两种方式影响宿主有关:①SARS病毒进入靶细胞诱导细胞凋亡;②SARS诱导机体的免疫反应,引起组织和器官的病变。
Severe acute respiratory syndrome (SARS), our country temporarily named acuteinfectious atypical pneumonia (acuteinfectious atypieal pneumonia, AIAP), referred to as atypical pneumonia (AP) is the epidemic in more than 30 countries in recent months And an acute infectious disease in the region, the disease is extremely dangerous and highly contagious. It is the focus of current international medical research. According to the results of 4 cases of systematic autopsy and 2 cases of consultation, the author analyzed the pathological features of SARS and its pathogenesis A brief overview of the mechanism. This study found that the pathological changes of SARS include lung lesions, immune organ damage, systemic small phlebitis, systemic toxic changes and secondary infection in four aspects. Lung lesions include pulmonary edema, alveolar epithelial hyperplasia, fusion, shedding, apoptosis is scaling changes in pneumonia, focal hemorrhagic necrosis, focal glomerulomatous pneumonia, a large number of transparent membrane formation of the lung, alveolar epithelium The virus inclusions and viral particles can be seen; immune organ damage, massive necrosis of the spleen lymphoid tissue, focal necrosis of the lymph nodes; systemic small phlebitis; systemic venules around the small organs and vessel wall edema, focal fibrosis , Infiltration of monocytes and lymphocytes, thrombosis in some small veins; systemic toxic changes and secondary infections; systemic degeneration and necrosis of multiple organ cells and secondary mold infections. Lung and immune organs are the major target organs for SARS virus attacks. The pathogenesis of SARS is unclear, and may be related to the host after SARS virus enters the body through two ways: ①SARS virus into target cells to induce apoptosis; ②SARS induces the body’s immune response, causing tissue and organ lesions.