上海地区肾综合征出血热尸检肾组织病毒检测

Detection of virus infection in renal tissues of autopsy with hemorrhagic fever renal syndrome

目的：研究上海地区肾综合征出血热（ＨＦＲＳ）尸检病例肾脏组织中病毒ＲＮＡ及抗原的分布及定位。方法：用核酸原位分子杂交方法和细胞免疫组化方法，检测１７例ＨＦＲＳ尸检肾组织中病毒。结果：在１７例肾组织中１５例可检测到病毒ＲＮＡ及抗原，病毒ＲＮＡ主要位于肾组织血管壁、毛细血管内皮细胞及部分肾小球毛细血管内皮细胞。病毒抗原主要分布于肾间质血管内皮细胞和血管壁中，部分位于肾曲管上皮细胞，以病毒包涵体样颗粒出现。结论：提示出血热病毒具有感染内皮细胞的特性，对宿主细胞有一定的致病作用。发现该病毒ＲＮＡ与抗原的表达趋于一致性。

Purpose Virus antigens and virus RNA were simultaneously detected in autopsy renal tissues of the patients with hemorrhagic fever renal syndrome(HFRS). Methods Virus antigens and virus RNA in cases of 17 autopsy renal tissues were derected by in situ hybridization and immunohistochemical techniques. Results Seventeen cases from Shanghai HFRS endemic region were subjected to virus antigens and rirus RNA detection and 15 cases positive. Virus RNA was mainly distributed in the renal vasculatures and endothelial cells, occasionally in glomerular tufts and tubular cells. In 9 of 15 cases, cytoplasmic inclusion body(IB) was detected in the distal convoluted and collecting tubular epithelium, which was positive for viral nucleocapsid protein(NP) and hemagglutinin antigen(HA). Conclusions These findings indicate that Hantaan virus could infect both the endothelial cells and (or) renal tubular epithelium and produce IB in the tubular epithelium in kidney. The immuno mediated mechanisms might also be involved in the tubular damage and vascular lesions.