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目的对严重急性呼吸综合征(SARS)患者脾淋巴细胞进行定量分析,为SARS的病理变化和发病机制的探讨提供证据。方法通过免疫组织化学技术对6例SARS死亡患者脾和6例意外死亡者正常脾CD3+、CD4+、CD8+T细胞及CD20+B细胞的分布进行观察,并进行图像分析。结果SARS患者脾内的脾小体及动脉周围淋巴鞘(白髓)均遭到严重损害。动脉周围淋巴鞘的数量减少90·39%;脾小体减少80%左右,有的甚至完全消失;脾红髓广泛出血坏死。红髓内的CD3+T细胞平均数较正常减少71·76%,有的甚至完全消失,CD4+T细胞和CD8+T细胞分别平均减少86%和84%。CD20+B细胞减少80%以上。结论定量分析显示,SARS死亡患者脾中T细胞和B细胞普遍严重减少,提示SARS患者免疫系统遭到严重破坏,并可能是疾病的原发性损伤。
Objective To quantitatively analyze splenic lymphocytes in patients with severe acute respiratory syndrome (SARS) and provide evidence for the pathological changes and pathogenesis of SARS. Methods The distribution of splenic CD3 +, CD4 +, CD8 + T cells and CD20 + B cells in spleen and 6 cases of accidental death in 6 SARS patients were observed by immunohistochemistry and image analysis was performed. Results The splenic bodies and periarterial lymphatic sheath (white pulp) in SARS patients were seriously damaged. Peripheral arteries reduced the number of lymphatic sheath 90 · 39%; spleen reduced by about 80%, and some even completely disappeared; splenic red meatal hemorrhage and necrosis. The average number of CD3 + T cells in the red pulp decreased by 71.76% compared with the normal ones, and some even completely disappeared. On average, the percentages of CD4 + T cells and CD8 + T cells decreased by 86% and 84% respectively. CD20 + B cells decreased by more than 80%. Conclusions Quantitative analysis showed that the splenic T cells and B cells in SARS patients were severely reduced, suggesting that the immune system of patients with SARS was severely damaged and may be the primary lesion of the disease.