肾综合征出血热人体组织中病毒包涵体的性质及意义的进一步研究

Further Characterization of Vial Inclusion Body in the Autopsy Tissues of Patients Suffered from Hemorrhagic Fever with Renal Syndrome

应用免疫组化、原位分子杂交、电镜及免疫电镜等方法进一步对肾综合征出血热人体尸检组织中病毒包涵体（ＩＢ）的抗原、核酸性质和超微结构特点作了进一步观察。结果，在３９例中的２０例尸检病例组织中显示出病毒核蛋白抗原和血凝素抗抗原阳性的ＩＢ，其中包括１６例陕西尸检病例组织中的６例休克期和１例多尿期病例，１７例上海病例中的３例休克期和９例少尿期病例及３例江西病例中的１例休克期病例。ＩＢ主要分布在呼吸道和肺泡、肾远曲小管和集合管、胃肠道、腺垂体、扁桃体、胰腺、前列腺等组织的粘膜上皮和腺上皮细胞及肝细胞和睾丸生精上皮细胞胞浆中，阳性细胞形态基本正常。应用原位分子杂交，可在该组细胞小同时检测到病毒ＲＮＡ，多为胞浆内弥漫阳性，仅少数组织中显示出病毒ＲＮＡ阳性ＩＢ结构。电镜观察阳性组织细胞中出现由大量微丝微管及颗粒样结构组成的ＩＢ结构，其小的病毒颗粒状结构、内质网及纤维丝状结构呈病毒抗原阳性，上述结构位于高尔基体区。结果说明该病毒有感染上皮细胞的特性，对其宿主细胞的致细胞病变作用是极其温和的，且多表现在亚细胞水平。ＩＢ可能是病毒过量表达抗原的堆积或病毒复制部位，而微丝微管结构可能参与病毒的感染过程。

mmunocytochemistry and in situ hybridization were performed on the autopsy tissues of 39 fetal cases of patients with hemorrhagic fever with renal syndrome to search for viral in-clusion body(IB)and study its antigenic and nucleic acid characters.The tissues with IB were further observed by electron and immunoelectron microscope.Immunohistochemically,IB,a coarse cytoplasmic granule. was positive for anti-nucleocapsid and hemogglutinin antibody,but negative for anti-evelope protein antibody.It was found in 20 of 39 cases including 10 cases died at hypotensive phase,9 cases died at oliguric phase and 1 case died at diuretic phase of HFRS,and distributed in the renal distal convoluted and collecting tubular cells,hepatocytes mucosal and glandular epithelial cells of respiratory tract,alveolar sacs,gastroin-testinal tract,tonsil,salivary gland,pallcreas,prostate gland and pituitary gland,and seminif-erous epithelial cell of testis,etc.The similar granules with viral RNA positive were observed only in a small part of IB positive tissues. U Itrastructurally.IB consisted of an accumulation of granular or filamentious materials,or both.They were seen near well-developed Golgis apparatus and associated with well-developed rough endoplasmic reticulum and increased numbers of ribosomes. Viral antigens were mainly localized in the aggregated virion-like par-ticles,reticuloendothelium and filamentious structures.From the results obtained here,it was concluded that IB consisted mainly of the viral nucleocapsid protein but less virus RNA;han-tavirus was hilghly infectious for epithelial cells of human body;and the excess production of viral antigen which accumulated as IB might result in the cellular damages.