【摘要】 目的:研究重症甲型H1N1流感病毒肺炎患者的临床病理学特点。方法:分析12例重症甲型H1N1流感患者临床表现特点;5例患者临床死亡5min内穿刺获取支气管、肺、心肌、腓肠肌和肝脏组织,对各组织分别行苏木素-伊红染色、吉姆萨染色,透射电子显微镜标本制备;分别用光镜和透射电子显微镜观察各个脏器的病理学变化。结果:支气管黏膜和肺泡上皮广泛损伤,Ⅱ型肺泡上皮细胞和成纤维细胞增生,肺组织实变和纤维化显著。心肌和腓肠肌局灶性损伤和坏死,部分区域纤维化。肝细胞广泛脂肪化,小叶中央静脉和汇管区周围坏死。支气管、肺、肝、心肌和腓肠肌损伤坏死区域有大量病毒,轻度损伤和结构完整部位病毒数量少。结论:甲型H1N1流感病毒不仅能够直接感染呼吸系统引起单纯性病毒性肺炎和严重肺损伤,而且能侵犯多个器官,导致重症患者多脏器功能衰竭和死亡。更多还原

【Abstract】 Objective: To study the pathology characteristics in patients with severe influenza A/H1N1 virus infection. Methods: The clinical data were analysed in 12 patients with influenza A/H1N1 virus infection. Samples of bronchial, lung, myocardium, gastrocnemius and liver were obtained from 5 patients within 5 min of clinical death. The tissue samples were stained and studied with transmission electron microscope pathologically. Results: It was found that tunica mucosa bronchio rum and alveolus were damaged or necrotic seriously. Type Ⅱalveolar epithelial cells and fibroblasts proliferated heavily. There were significant consolidation and fibrosis in lung tissues. There were local damage and necrosis in myocardium and gastrocnemius. It was also found the extensive development of fat within liver cells and necrosis around lobular central vein and portal area. A large number of viral particles were found in the damaged or necrotic regions of bronchus, lung, liver, myo cardium and gastrocnemius,but fewer in slight damaged or integrity areas. Conclusion: Influenza A/ H1N1 viruses not only could directly infect pulmonary system leading to the viral pneumonia and distress of respiratory syndrome, but also could in vade other organs in severe case, causing multiple organ dysfunction and death.更多还原