摘要
本文对42例EHF患者的皮疹微血管及8例死后肝穿组织和5例尸检肝脾肺肾组织的微血管做了病理组织学观察,同时对患者的血小板进行了同步计数检查。结果表明:上述组织的微血管内皮细胞肿胀,退变、坏死,管壁狭窄或闭塞,基底膜裸露,甚至破裂出血。间断连续切片还证明,微血管病为节段性,1/3以上的病例有微血栓形成,血小板明显减少。证明微血管壁结构的破坏是EHF出血的直接原因,血管内皮细胞的坏死、脱落,其下胶原纤维裸露,对微血栓形成有启动因素作用。血栓继发性纤溶和血小板减少是造成出血和皮疹的重要继发因素。
In this paper the pathological histology of the rashes of 42 EHF patients was observed. The platelet counts were performed at the same time. Pathological histology of post mortem viscerol organs(liver,spleen,lungs and kidneys) of 5 cases and 8 cases needle biopsy of liver of EHF were also investigated. The results showed that the endothdlial cells of the microvessels showed a swelling,degenerative change and necrosis. The vascular calibres were reduced or totally obliterated. The basement membranes were exposed and showed breakage at places where hemorrhage can be seen. Internal serial sectioning revealed that the changes were segmental. Micro—thrombosis were observed in one—third of the cases. Platelete counts were reduced obviously. All this evidences suggest that the destruction of the structures of the micro—vessel wall is the direct catise of hemorrhagic phenomena in EHF. The necrosis and exfoliation of endoepithelial cells followed by exposure of the collagenous fiber constitute the initiating factor or microthrombosis. The fibrinolysis after thrombus formation and reduction in number of plateletes constitutes the main cause of hemorrhage and rash formation in EHF.
关键词
流行性出血热
微血管
病理改变
epidemic hemorrhagie fever
microvessel
pathologic change
