Duan Xue-jing, Li Yong, Gong En-cong, Wang Jue, Lü Fu-dong, Zhang He-qiu, Sun Lin, Yue Zhu-jun, Song Chen-chao, Zhang Shi-Jie, Li Ning, Dai Jie
Department of Pathology, Capital Medical University, Beijing, China.
Zhonghua Bing Li Xue Za Zhi. 2011 Dec;40(12):825-9.
To study the pulmonary pathology in patients died of fatal human influenza A(H1N1) infection.
Eight cases of fatal human influenza A (H1N1) infection, including 2 autopsy cases and 6 paramortem needle puncture biopsies, were enrolled into the study. Histologic examination, immunohistochemitry, flow cytometry and Western blotting were carried out.
The major pathologic changes included necrotizing bronchiolitis with surrounding inflammation, diffuse alveolar damage and pulmonary hemorrhage. Influenza viral antigen expression was detected in the lung tissue by Western blotting. Immunohistochemical study demonstrated the presence of nuclear protein and hemagglutinin virus antigens in parts of trachea, bronchial epithelium and glands, alveolar epithelium, macrophages and endothelium. Flow cytometry showed that the apoptotic rate of type II pneumocytes (32.15%, 78.15%) was significantly higher than that of the controls (1.93%, 3.77%).
Necrotizing bronchiolitis, diffuse alveolar damage and pulmonary hemorrhage followed by pulmonary fibrosis in late stage are the major pathologic changes in fatal human influenza A (H1N1) infection.
研究死于致命性甲型H1N1流感感染患者的肺部病理学特征。
纳入8例死于致命性甲型H1N1流感感染的病例，其中包括2例尸检病例和6例濒死期经皮肺穿刺活检病例。进行了组织学检查、免疫组织化学、流式细胞术及蛋白质免疫印迹分析。
主要病理改变包括伴有周围炎症的坏死性细支气管炎、弥漫性肺泡损伤及肺出血。通过蛋白质免疫印迹分析在肺组织中检测到流感病毒抗原表达。免疫组织化学研究显示在部分气管、支气管上皮及腺体、肺泡上皮、巨噬细胞及内皮细胞中存在核蛋白及血凝素病毒抗原。流式细胞术显示Ⅱ型肺泡上皮细胞的凋亡率（32.15%，78.15%）显著高于对照组（1.93%，3.77%）。
坏死性细支气管炎、弥漫性肺泡损伤及肺出血，后期继以肺纤维化是致命性甲型H1N1流感感染的主要病理改变。
