创伤弧菌感染致多器官损伤的超微结构观察及致病机制

Ultrastructural observation on the multi-organ injuries caused by infection by Vibrio vulnificus and the pathogenesis

目的 :通过电镜观察创伤弧菌 (Vibriovulnificus ,Vv)所致多器官损伤的超微结构改变情况 ,探讨其发病机制。方法 :临床组 6例 ,取自临床Vv感染的皮肤、肌肉的活检组织 ;实验组 12只昆明小鼠 ,在腹腔、肌肉、皮下 (各 4只 )接种Vv菌液 0 .2ml/只 (约 4.3 4× 10 6 CFU) ;对照组 4只昆明小鼠 ,腹腔注射无菌生理盐水0 .2ml/只。分别取血液、皮肤、肌肉、心肌、肺、肝、肾等组织进行电镜观察。结果 :电镜下见皮肤、肌肉、心肌、肺、肝、肾等组织的部分实质细胞内和间质中可见Vv生长 ;血液内见大量Vv菌体 ;部分血管内皮细胞损伤及基膜断裂溶解 ,线粒体、内质网等细胞器损伤明显。结论 :Vv引发的原发性败血症以及多器官实质细胞及间质超微结构损伤 ,致使多器官功能障碍甚或衰竭 。

Objective: To observe the ultrastructural change of the multi-organ injuries caused by the infection with Vibrio vulnificus under the electron microscope and discuss the pathogenesis.Methods:skins and musceles infected by Vv were collected from t he clinical biopsy of 6 cases in the clinical group;Vv bacterial fluid 0.2 ml/ea ch mouse(about 4.34×10 6CFU/0.2 ml)was inoculated into the abdominal cavity,muscles and subcutancous tissue in the experimental group of 12 Kum Ming mice an d the sterile physiological saline solution was injected into the peritoneal cav ity of 4 mice of the control group.The tissues taken from blood,skin,muscle, myocardium,lung,liver and kidney were observed under EM.Results:Growth of Vv was seen in the partial parenchymal cells and the interstitial tiss ues of the skin,muscle,myocardium,lung,liver and kidney.A great number of Vv tha lli was detected in the blood.The endothelial cells of the parts of the vessels were damaged and the basement membrane were broken and dissolved.The organelle,s uch as the mitochondria and endoplasmic reticula were damaged obviously.Conclusion:The primary septicemia caused by Vv and the ultrastr uctural damages of the parenchymal cells and the interstitial tissues led to mul ti-organ's dysfunction and failure in and importand reason of body quick death.