小儿巨细胞包涵体病组织中病毒抗原检测及其临床意义的研究

目的　探讨小儿巨细胞病毒（ＣＭＶ） 感染组织病变及与临床的关系。方法　用免疫组化链霉菌抗生物素蛋白过氧化物酶连结法（简称ＳＰ法），检测４４ 例小儿巨细胞包涵体病（ＣＩＤ） 尸检腮腺、肺、肾、肝组织石蜡切片组织中ＣＭＶ感染情况。结果　ＣＭＶ不仅存在于包涵体巨细胞，还广泛存在于无包涵体形成的巨细胞及形态正常的细胞。腮腺、肺、肾、肝组织ＣＭＶ抗原阳性率分别为９１ ％ 、５９ ％ 、３７％ 、２７％ 。６２％ 的全身型ＣＩＤ合并多脏器受累。肺组织炎症反应级别和临床症状的轻重与肺ＣＭＶ感染的严重程度平行相关。结论　ＣＭＶ感染细胞广泛，有些感染细胞无形态学变化。全身型ＣＩＤ 易合并多脏器受累。ＣＭＶ 相关性肺炎以间质性肺炎为主，且ＣＭＶ 在其中可能起主导作用。

Detection of cytomegalovirus antigen in tissues by immunohistochemistry and its clinical significance in cytomegalic inclusion body disease of children

Objective To investigate the relationship between the pathological changes of CMV infection in children and clinical manifestations Methods Parraffin embeded parotid gland, lung, kidney and liver tissue sections prepared from autopsy material of 44 infants died of cytomegalic inclusion body disease (CID) were used to detect CMV antigen by immunohistochemistry (streptavidin peroxidase or S P method) Results CMV antigen was detected not only in most of cytomegalic cells with cytomegalic inclusion bodies (CIB) but also in many non CIB cytomegalic cells and morphologically normal cells CMV antigen was detected in 91% of parotid gland tissues, 59% of lung tissues, 37% of kidney tissues and in 27% of liver tissues 62% of the patients with generalized CID had multiple sites involvement Grades of inflammation in lungs and severity of symptoms correlated directly with the severity of CMV infection in lungs Conclusion CMV infected cells were widespread, some of them had no morphological changes Patients with generalized CID more often had multiple sites involvement than those without generalized CID Sections from most of CMV related pneumonia cases showed histological features of interstitial pneumonia, and CMV may play a leading role in the pathogenesis of the pneumonia