多器官功能障碍综合征52例尸检脾及脾树突状细胞的病理学观察

目的探讨多器官功能障碍综合征（MODS）脾及其树突状细胞的病变特点与作用。方法收集52例MODS死亡病例与25例正常脾标本,应用光镜、电镜和免疫组化（S-100、CD1a、CD80及HLA-DR）方法观察脾及其树突状细胞的病理变化。结果镜下见脾小体消失,白髓消散伴淋巴细胞大量凋亡,树突状细胞数目增加而活性减退,CD4（＋）/CD8（＋）T淋巴细胞比例显著下降。结论MODS终末期外周免疫器官脾及其树突状细胞严重损伤和功能耗竭,而且不同诱因所致MODS病例的病变基本一致。提示脾树突状细胞的病变与免疫抑制及MODS形成有重要关系。

Pathologic alteration of spleen and its dendritic cells in patients with multiple organ dysfunction syndrome: An observation of 52 autopsied cases

Objective To explore the pathological features of spleen and its dendritic cells(DCs)and to study their role in the multiple organ dysfunction syndrome(MODS).Methods The changes of spleen and its DCs in the spleen in 52 MODS cases were studied using the methods of light microscopy,electronic microscopy and immunohistochemistry(S-100,CD1a,CD80 and HLA-DR).Results The splenic lymphoid nodules disappeared,white pulp was atrophied and a lot of lymphocytes apoptosed.The content of DCs increased but the function decreased.CD4/8 ratio declined markedly in spleen.Conclusion In the MODS stage,there are severe pathological changes and dysfunction in spleen and DCs,and MODS cases from different causes show the same changes.It is suggested that there is an important relation between spleen dendritic cells changes and pathogenesis of MODS.