用原位分子杂交和免疫组化研究肾综合征出血热肾组织中的病毒感染

Hemorrhagic Fever with Renal Syndrome(HFRS)Virus Infection in the Renal Tissues of Patients with HFRS Studied by in situ Hybridization and Immunohistochemistry

应用原位分子杂交和免疫组化技术研究了陕西、沈阳、上海、江西、广州等地收集的３６例肾综合征出血热（ＨＦＲＳ）尸检肾组织中的病毒ＲＮＡ和抗原的定位和分布。病毒ＲＮＡ检测３４例，２８例阳性；抗原检测３４例，３０例阳性，病毒ＲＮＡ及其抗原主要定位于细胞胞浆中。西安及沈阳地区的病例，病毒ＲＮＡ和抗原阳性部位主要是肾小管上皮细胞，较少出现血管阳性。上海、江西和广州地区病例病毒ＲＮＡ主要出现于肾间质血管和少数病例的个别肾小球毛细血管和肾小管上皮细胞；病毒抗原分布于肾间质血管和肾小管上皮中。１例（广州病例）肾血管平滑肌细胞检测到空泡状病毒ＮＰ抗原。另外在３例西安病例和９例上海病例肾远曲小管和集合管上皮中检测到ＮＰ和ＨＡ阳性的病毒包涵体。结果说明ＨＦＲＳ病毒可感染肾脏中肾小管上皮和血管内皮，并在肾小管上皮细胞产生包涵体。不同地区病例肾脏中病毒感染的部位不同，可能与不同地区病例所感染的病毒毒株或血清型不同有关。肾小管上皮细胞和血管内皮的损伤除病毒直接作用外，还可能有免疫因素参与。

emorrhagic fever with renal syndrome(HFRS)virus RNA and antigens were simultane-ously detected by in situ hybridization and immunohistochemical techniques in the autopsy renaltissues of the patients with HFRS.In 36 cases collected separately from Shaanxi,Shenyang,Shanghai and Jiangxi HFRS endemic foci,34 cases were subjected to virus RNA detection and 28cases were positive,34 cases were subjected to viral antigen detection and 30 cases were positive.Virus RNA and antigens were mainly localized in the cytoplasm,In the cases from Xi'an andShenyang,they were mainly distributed in the renal tubular cells.In the cases from Shanghai,Jiangxi and Guangzhou.virus RNA was mainly distributed in the renal interstitial vasculaturesand endothelial cells,occasionally in glomerular tufts and tubular cells,while viral antigens weredistributed in vasculatureb and renal tubular cells,and in Guangzhou cases in smooth muscles ofblood vessels。 Moreover,3 cases from Xi′an and 9 cases from Shanghai also displayed cytoplasmicinclusion bodies(CIB)in their distal convoluted and collecting tubular celis,which were positivefor viral nucleocapsid protein(NP)and hemagglutinin(HA).These findings indicated that HFRSvirus could infect both the endothelial cells and/or renal tubular cells and produce CIB in the tubu-lar cells in kidney The variance of target cells.fvirus infection may be related to the different vi-ral strains or serotypes prevailed in different HFRS endemic foci.The immunemediated mecha-nism,besides virus direct attack,might be involved in the tubular damage and vascular lesion.