流行性出血热出血机理的探讨

为阐明流行性出血热(简称出血热)的出血机理,我们将31例出血热患者各病期血小板和红细胞涂片,用羊抗人IgG和C3荧光素作荧光染色后,再用出血热单克隆荧光抗体作特异性染色。血小板、红细胞表面的免疫复合物在发热期即出现,检出率分别为33.3％和25.8％,至休克少尿期仍存在,到多尿和恢复期则基本消失。发热期患者的血小板计数及其聚集率均显著下降。各病期血标本纤维蛋白原半定量测定的结果均属正常。但纤维蛋白(原)裂解产物(FDP)在发热期已有增高,休克少尿期增高显著,多尿期仍高于正常。直至恢复期渐趋正常。本文资料提示免疫复合物在组织细胞表面沉积是引起出血的重要原因。

A STUDY ON THE PATHOGENESIS OF HEMORRHAGE IN EPIDEMIC HEMORRHAGIC FEVER

In an attempt to clarify the pathogenesis of hemorrhage in epidemic hemorrhagic fever (EHF), platelet and rbc smears obtained from 31 cases in various stages of this disease were stained with fluorespein labelled anti-human IgG and C3, and then stained for fluorescein labelled specific monoclonal antibody in the positive cases. The results indicated that the immune complex was present on the surface of platelets and rbc early in the febrile stage, with a detection rate of 33.3% and, 25.8% respectively. It was still present in the shock-oliguric stage, but disappeared in the polyuric and convalescent stages. The platelet count and it3 aggregation rate were reduced significantly during the febrile stage. Plasn a fibrinogen, determined semi-quantitatively, in various stages of EHF were normal. But fibrin degradation product (FDP) levels were elevated in the febrile stage. The increase was particularly marked in the shock-oliguric stage, remained abnormal in the polyuric stage, and gradually returned to normal in the convalescent stage. The aforementioned results suggest that immune complex deposition on the surface of tissue cells may be the main factor which leads to hemorrhage.