A clinicopathological study of three cases of severe acute respiratory syndrome (SARS).
A clinicopathological study of three cases of severe acute respiratory syndrome (SARS).
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DOI：
10.1080/00313020310001619118
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发表时间：
2003-12
期刊：
影响因子：
4.5
通讯作者：
Dwyer DE
中科院分区：
文献类型：
--
作者：
Lang ZW;Zhang LJ;Zhang SJ;Meng X;Li JQ;Song CZ;Sun L;Zhou YS;Dwyer DE
2003年3月上旬，严重急性呼吸系统综合症（SARS）在中国北京引起了大规模非典型肺炎疫情。我们报告了三名死于SARS的患者的病理特征。对发病后 9-15 天死亡的 3 名患者进行了尸检，并对临床和实验室特征进行了审查。组织切片用苏木精和伊红 (H&E) 染色，并使用 SARS 冠状病毒特异性引物对肺切片进行原位逆转录酶聚合酶链反应 (RT-PCR)。肺部典型的大体病理改变是肺表面弥漫性出血。组织病理学检查显示大多数肺泡存在浆液性、纤维蛋白性和出血性炎症，伴有毛细血管充血和一些毛细血管微血栓形成。肺泡增厚，间质单核炎症浸润，弥漫性肺泡损伤，肺泡细胞脱落，透明膜形成；纤维蛋白样物质和红细胞存在于肺泡腔中。部分支气管小动脉有血栓栓塞。淋巴结和脾脏中观察到出血性坏死和淋巴细胞数量减少。原位 RT-PCR 在所有 3 名患者的 II 型肺泡细胞、间质细胞和细支气管上皮细胞中均检测到 SARS 冠状病毒 RNA 肺组织的严重免疫损伤是 SARS 临床特征的原因。
The severe acute respiratory syndrome (SARS) caused a large outbreak of atypical pneumonia in Beijing, China from early March 2003. We report the pathological features from three patients who died of SARS. Autopsies were performed on three patients who died 9–15 days after the onset of the illness, and the clinical and laboratory features reviewed. Tissue sections were stained with haematoxylin and eosin (H&E), and in situ reverse transcriptase polymerase chain reaction (RT–PCR) on lung sections was performed using SARS coronavirus-specific primers. The typical gross pathological change in the lungs was diffuse haemorrhage on the lung surface. Histopathological examination revealed serous, fibrinous and haemorrhagic inflammation in most pulmonary alveoli, with capillary engorgement and some capillary microthrombosis. The pulmonary alveoli were thickened with interstitial mononuclear inflammatory infiltrates, diffuse alveolar damage, desquamation of pneumocytes and hyaline-membrane formation; fibrinoid material and erythrocytes were present in alveolar spaces. There were thromboemboli in some bronchial arterioles. Haemorrhagic necrosis and reduced numbers of lymphocytes were observed in lymph nodes and spleen. In situ RT–PCR detected SARS coronavirus RNA in type II alveolar cells, interstitial cells and bronchiolar epithelial cells from all three patients Severe immunological damage in lung tissue is responsible for the clinical features of SARS.
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DOI：
10.1016/s0140-6736(03)13077-2
发表时间：
2003-04-19
期刊：
Lancet (London, England)
影响因子：
--
作者：
Peiris JS;Lai ST;Poon LL;Guan Y;Yam LY;Lim W;Nicholls J;Yee WK;Yan WW;Cheung MT;Cheng VC;Chan KH;Tsang DN;Yung RW;Ng TK;Yuen KY;SARS study group
通讯作者：
SARS study group
DOI：
10.1016/s0140-6736(03)13413-7
发表时间：
2003-05-24
期刊：
Lancet (London, England)
影响因子：
--
作者：
Nicholls JM;Poon LL;Lee KC;Ng WF;Lai ST;Leung CY;Chu CM;Hui PK;Mak KL;Lim W;Yan KW;Chan KH;Tsang NC;Guan Y;Yuen KY;Peiris JS
通讯作者：
Peiris JS
DOI：
10.1016/s0140-6736(03)13414-9
发表时间：
2003-05-24
期刊：
Lancet (London, England)
影响因子：
--
作者：
Ruan YJ;Wei CL;Ee AL;Vega VB;Thoreau H;Su ST;Chia JM;Ng P;Chiu KP;Lim L;Zhang T;Peng CK;Lin EO;Lee NM;Yee SL;Ng LF;Chee RE;Stanton LW;Long PM;Liu ET
通讯作者：
Liu ET
DOI：
10.1001/jama.289.21.joc30885
发表时间：
2003-06-04
影响因子：
120.7
作者：
Booth, CM;Matukas, LM;Detsky, AS
通讯作者：
Detsky, AS
影响因子：
158.5
作者：
Poutanen, SM;Low, DE;McGeer, AJ
通讯作者：
McGeer, AJ