【摘要】 目的通过对严重急性呼吸综合征(SARS)肺组织中CD34、血管内皮生长因子(VEGF)和细胞间黏附分子(ICAM-1)表达水平的检测对其发病机制进行探讨。方法将7例死亡SARS病例及同期6例具有急性肺损伤性临床表现的非SARS死亡病例肺标本对照进行HE染色及CD34、VEGF、ICAM-1免疫组化检查,并对免疫组化染色结果进行图像分析。结果CD34染色结果显示SARS组肺毛细血管内皮细胞着色浓重胞膜完整、排列紊乱但细胞连续性好,平均光密度值(MOD)为0.2843±0.1033;非SARS组肺组织CD34染色浅淡、不连续,MOD值为0.1297±0.0073,两组结果差异有显著性(P=0.0074);不合并细菌或真菌感染SARS标本的MOD值为0.3428±0.0316,与非SARS组结果差异有显著性(P<0.0001)。SARS组VEGF阳性染色MOD为0.1253±0.042,与非SARS组0.1143±0.0252相比,结果差异无统计学意义(P=0.5888)。两组ICAM-1阳性染色MOD值差异无统计学意义;但不合并感染的SARS标本ICAM-1MOD值为0.2557±0.0452,与非SARS组0.182±0.017相比,结果差异有统计学意义(P=0.006)。结论SARS肺脏中内皮细胞的损伤程度较之其他原因引起的肺组织损伤轻,ICAM-1和VEGF表达也存在不同,这些差异可能反映了SARS肺损伤的特殊性,对解释SARS的临床和病理生理过程具有一定意义。更多还原

【Abstract】 Purpose To study the possible pathogenesis of severe acute respiratory syndrome(SARS)by comparing the protein expression of CD34,VEGF and ICAM-1 in SARS lungs with those in non-SARS lung injury.Methods Specimens,from 7 cases of diagnosed SARS and 6 non-SARS cases died with acute lung injury,were examined by routine HE and immunohistochemical stains of CD34,VEGF and ICAM-1,and then image analysis.Results The blood vessels in SARS lungs outlined the alveolus clearly,and its mean optical density(MOD)was 0.284 3±0.103 3,which was significantly greater than that of non-SARS lungs(0.129 7±0.007 3,P=0.007 4).The MOD of VEGF of the two groups had no statistical difference.The MOD of ICAM-1 in SARS lung was significantly increased in the cases without infectious morbidity(P=0.041 6).Conclusion The endothelial cells in SARS lungs are injured not so seriously as compared with those of infectious lung injury.The expression of ICAM-1 and VEGF is also different,which may reflect the characteristics of SARS lung injury and explain the clinical process of SARS partly.更多还原