流行性出血热发病机理的研究

A STUDY ON THE PATHOGENESIS OF EPIDEMIC HEMORRHAGIC FEVER

流行性出血热的发病机理迄今未明。本文对出血热的发病与免疫关系进行了研究,发现本病的免疫反应处于明显异常状态,表现为体液免疫亢进、补体下降、细胞免疫受抑制.患者体内的循环免疫复合物检出率达100%,并在疾病的急性期呈强阳性者占96%,病愈后逐渐转为阴性。7例病员作了肾活检,应用电镜和免疫荧光染色法检测,发现在肾小球基底膜有成堆免疫复合物沉积。应用免疫抑制药物环磷酰胺治疗本病156例,获得了较好效果,特别是早期治疗的病员,90%以上不出现严重的低血压期或/和少尿期,从而使病死率明显下降至1.3%.本文对出血热的发病机理作了讨论,提出宿主的免疫反应在本病的发生和发展上起了重要作用,而感染的病毒只起始动作用。

The relationship between the pathogenesis of epidemic hemorrhagic fever and theimmunoreaction of host had been studied.The humoral immune responses of the patients,as indicated by the serum immunoglobulin level,were increased and the serum complementlevel became significantly lower than the normal value prior to treatment.Meanwhile,the cellular immune responses were suppressed.The circulating immune complex wasdetermined in 52 out of 156 cases with positive results in all cases(50 cases(96%)strongly positive even in the early stage).After recovery,the circulating immune complexbecame negative.Electron microscopic and immunofluorescent studies made in 7 kidneybiopsy specimens showed deposition of the immune complexes along the glomerular basementmembrane.On this immunologic groung,156 cases of epidemic hemorrhagic fever weretroated with immunosuppreesive agent,cyclophosphamide,during the period of 1973-1979,and excellent therapeutic results were obtained with only 2 deaths.