CAJ | 학술논문

目的:观察人感染甲型H1N1流感病毒重症死亡病例各主要脏器的病理改变.方法:按传染病尸体解剖要求对3例死亡病例进行系统解剖,并获得心、肝、脾、肺、脑和肾等全部脏器,组织常规HE染色和革兰氏染色,光学显微镜下观察.结果:3例病例主要致死性病变位于肺,呈现弥漫性肺泡损伤改变(坏死性细支气管炎、肺泡腔内有浆液性和/或纤维素性渗出、肺出血、肺透明膜形成),其中1例病程较长者部分区域伴肺泡上皮增生和肺间质纤维化,且合并细菌感染及肺脓肿,可见血管壁坏死,血管内血栓形成,1例有心肌水肿,1例有脑出血和脑液化性坏死.结论:人感染甲型H1N1流感病毒后主要累及呼吸系统,患者最终因急性呼吸窘迫综合征和多器官功能衰竭死亡.
목적:관찰인감염갑형H1N1류감병독중증사망병례각주요장기적병리개변.방법:안전염병시체해부요구대3례사망병례진행계통해부,병획득심、간、비、폐、뇌화신등전부장기,조직상규HE염색화혁란씨염색,광학현미경하관찰.결과:3례병례주요치사성병변위우폐,정현미만성폐포손상개변(배사성세지기관염、폐포강내유장액성화/혹섬유소성삼출、폐출혈、폐투명막형성),기중1례병정교장자부분구역반폐포상피증생화폐간질섬유화,차합병세균감염급폐농종,가견혈관벽배사,혈관내혈전형성,1례유심기수종,1례유뇌출혈화뇌액화성배사.결론:인감염갑형H1N1류감병독후주요루급호흡계통,환자최종인급성호흡군박종합정화다기관공능쇠갈사망.
Objective:To find histopathological changes on major organs of Influenza A H1N1-infected patients and its relationship to clinical symptoms.Methods:The autopsies were performed following con-ventional protocols and strict safety procedures.Tissue samples from all major organs of three cases were collected and fixed in 4%formalin.The histopathological changes on these samples were observed under a light microscope.Results:The lungs of some damaged areas of three cases showed diffuse alveolar da mage(DAD)with hyaline membranes formation and intra-alveolar edema and/or fibrin.Most areas of the lungs in the three cases showed necrotizing bronchiolitis,hemorrhage,secondary infection,thrombsis and focal alveolar necrosis.The lungs exhibited proliferation of pneumocytes and fibrosis of the interstiti-um in one case.In one case,the brain showed focal hemorrhage and focal liquefactive necrosis.In one case,the heart showed edema.Conclusion:The respiratory tract is the major target of influenza A H1N1 virus.The changes of DAD with secondary infection in the lung resulted in hypoxia,leading to multiple organ failure and death.