流行性出血热流产婴儿与胎盘的病理变化及巨噬细胞内抗原定位

妊娠6~ 个月孕妇感染流行性出血热(EHF),临床有典型的EHF的发病过程。第23病日血清学检测孕妇外周血EHF-IgG(卅)、IgM(-),第24病日流产一女婴,抽取脐带血检测EHF-IgG(卅),流产女婴心血检测EHF-IgG(卅),IgM(-)。病理:肾小球上皮细胞肿胀,上皮细胞足突融合、坏死,毛细血管基底膜皱缩,肾小管上皮细胞线粒体肥大,间质内大单核细胞浸润。肺间质细胞增生、水肿、毛细血管基底膜不规则增厚,肺泡壁Ⅱ型细胞增多。肝细胞肿胀,胞浆内查见包涵体样物质,有多核肝巨细胞,地依红染色阴性。胎盘母体面、脐带、肺、肝间质内大单核细胞、中性粒细胞浸润。EHF-MCAb荧光直接法染色、PAP、ABC等免疫组化染色,在巨噬细胞浆内均为阳性反应,从而证实母体感染EHF可以经胎盘感染给胎儿,其传播方式可能是通过巨噬细胞系统。

PATHOLOGICAL STUDY OF INTRAUTERINE INFECTION OF EPIDEMIC HAEMOR- RHAGIC FEVER VIA PLACENTA

An EHF pregnant woman delivered a premature infant with the rather typical EHF changes. Anti-EHF-IgG was found both in the blood of the mother and the umbilical cord and in the heart of the infant. EHF antigens were detected positively with the labelled and unlabelied monoclonal antibodies by the direct fluorescent staining, and ABC and PAP immunohistochemical methods.The infiltration of macrophages in the interstitial tissues of the kidney, lung, placenta and umbilical cord was accompanied with a moderate inflammatory reaction.These results suggested that the transmission of the disease from a mother to an infant was through the placenta and the dissemination of the disease via the macrophage system.