CAJ | 학술논문

目的：建立肺孢子虫感染大鼠动物模型，并研究肺孢子虫感染引起的大鼠肺脏、肝脏及脾脏组织病理变化，为肺孢子虫致病机制研究提供依据。方法雌性 Wistar 大鼠54只，分成实验组和正常对照组。实验组大鼠37只，给予腹股沟皮下地塞米松注射，1 mg/次，2次/周；对照组大鼠17只，给予腹股沟皮下生理盐水注射，0.2 ml/次，2次/周。两组均给予含1 mg/ml 盐酸四环素水溶液喂养。第8周对所有大鼠进行解剖，取肺、肝及脾组织观察组织大体改变，制作肺、肝、脾印片及病理组织切片，观察模型建立效果及肺肝脾组织病理变化。结果经瑞士-姬姆萨染色证实，实验组37例肺组织印片中35例发现肺孢子虫包囊，占94.6%，肝脏及脾脏印片均未查见肺孢子虫包囊。病理检查发现肺泡上皮不同程度增生、肺泡腔内有多少不等的泡沫样渗出物、肺泡间质增宽、炎细胞浸润等病理变化，部分小血管周围多量浆细胞、淋巴细胞浸润，呈袖套样外观，少量肺泡腔扩张及肺组织实变；六亚甲基四胺银染色可见肺泡壁及肺泡腔渗出物中呈中心点状深染黑色包囊。肝小叶基本正常，肝细胞水肿变性占56.8%，汇管区及中央静脉旁炎细胞浸润达97.3%；脾脏红髓白髓清晰可见，红髓髓窦内可见红细胞，白髓内可见多核巨细胞。对照组中，肺脏、肝脏无明显病理变化，脾脏组织红髓髓窦内也可见红细胞，与实验组无明显差异。结论连续8周糖皮质激素注射可成功诱导肺孢子虫肺炎大鼠模型，检出率高达94.6%；糖皮质激素相关免疫低下与肺孢子虫感染发生密切相关；肺孢子虫感染大鼠肺脏及肝脏发生不同程度的病理变化，该模型可作为肺孢子虫致病机制及其他研究的平台。
목적：건립폐포자충감염대서동물모형，병연구폐포자충감염인기적대서폐장、간장급비장조직병리변화，위폐포자충치병궤제연구제공의거。방법자성 Wistar 대서54지，분성실험조화정상대조조。실험조대서37지，급여복고구피하지새미송주사，1 mg/차，2차/주；대조조대서17지，급여복고구피하생리염수주사，0.2 ml/차，2차/주。량조균급여함1 mg/ml 염산사배소수용액위양。제8주대소유대서진행해부，취폐、간급비조직관찰조직대체개변，제작폐、간、비인편급병리조직절편，관찰모형건립효과급폐간비조직병리변화。결과경서사-희모살염색증실，실험조37례폐조직인편중35례발현폐포자충포낭，점94.6%，간장급비장인편균미사견폐포자충포낭。병리검사발현폐포상피불동정도증생、폐포강내유다소불등적포말양삼출물、폐포간질증관、염세포침윤등병리변화，부분소혈관주위다량장세포、림파세포침윤，정수투양외관，소량폐포강확장급폐조직실변；륙아갑기사알은염색가견폐포벽급폐포강삼출물중정중심점상심염흑색포낭。간소협기본정상，간세포수종변성점56.8%，회관구급중앙정맥방염세포침윤체97.3%；비장홍수백수청석가견，홍수수두내가견홍세포，백수내가견다핵거세포。대조조중，폐장、간장무명현병리변화，비장조직홍수수두내야가견홍세포，여실험조무명현차이。결론련속8주당피질격소주사가성공유도폐포자충폐염대서모형，검출솔고체94.6%；당피질격소상관면역저하여폐포자충감염발생밀절상관；폐포자충감염대서폐장급간장발생불동정도적병리변화，해모형가작위폐포자충치병궤제급기타연구적평태。
Objective To establish an experimental model of pneumocystis pneumonia in Wistar rats and study the pathological changes of their lung, liver and spleen tissue for the study of PC pathogenesis. Methods Fifty-four female Wistar rats of clean grade were allowed to drink tetracycline solution with the concentration of 1 mg/ml and divided into two groups, the experimental group (n=37) with a subcutaneous injection of dexamethasone by a dose of 1 mg/time per rat twice a week and the control group (n=17) with the same way of injection by physiological saline simultaneously 0.2 ml per time. The pathological and etiological examinations were undertaken after 8 weeks. Results Wright-Giemsa Stain confirmed that PC cyst was found in the lung tissue printing of 35 cases (94.6%) in the experimental group, while no PC cyst was found in liver and spleen printing. The pathological examination showed that there were different degrees of alveolar epithelial hyperplasia, varying amounts of foamed exudates in alveolar cavity, alveolar mesenchyme broadening, inflammatory cells infiltration and other pathological changes; numerous plasma cells and sleeved lymphocytes infiltration could be observed around some small blood vessels, while a small amount of alveolar cavity was expanded and consolidation of the lung tissue could be found; GMS staining showed alveolar walls and exudates of alveolar cavity with deep-dyed black cyst in the center points. The hepatic lobule was basically normal and 56.8% of the liver cells were with edema and degeneration, while 97.3% of the inflammation cells were infiltrated in the portal area and near the central vein; red pulp and white pulp were clearly visible in spleen. 51.3% of the medullary sinus was full of red blood cells while multinuclear giant cells could be seen in white pulp. In the control group, no obvious pathological changes could be found in lung and liver, and red cells were visible in red pulp of spleen, which were not different with the experimental group. Conclusions Corticosteroid injections for 8 weeks could successfully induce the model of pneumocystis pneumonia in rats with the detection rate up to 94.6%. There was a strong link between PC infection and immunosuppression with glucocorticoid. Various degree of changes in the lung and the liver could be found by histologic examination. This animal model could be used as a platform of investigating the pathogenic mechanism and other study of PC infection.