【摘要】：目的分析馬爾尼菲籃狀菌感染組織中巨噬細(xì)胞極化與組織病理學(xué)改變以及臨床表現(xiàn)的聯(lián)系,初步探討馬爾尼菲籃狀菌逃脫宿主免疫防御的機(jī)制。方法收集16例HIV(-)的馬爾尼菲籃狀菌病患者皮損組織蠟塊和10例馬爾尼菲籃狀菌感染小鼠皮膚、肺、肝、脾組織蠟塊。組織蠟塊行HE染色,分析感染組織炎癥反應(yīng)模式,通過免疫組化技術(shù)檢測感染組織巨噬細(xì)胞CD86、CD163、Arg-1的表達(dá)情況�；仡櫺苑治�16例HIV(-)的馬爾尼菲籃狀菌病患者的臨床資料,分析巨噬細(xì)胞極化狀態(tài)與臨床表現(xiàn)的關(guān)系。結(jié)果1.16例HIV(-)馬爾尼菲籃狀菌病患者皮損組織病理表現(xiàn)為化膿性炎10例(62.50%)、化膿性炎并肉芽腫性炎5例(31.35%),壞死性炎1例(6.25%);炎癥為混合炎細(xì)胞(中性粒細(xì)胞、嗜酸性粒細(xì)胞、漿細(xì)胞、淋巴細(xì)胞、巨噬細(xì)胞)浸潤。10例小鼠感染組織均表現(xiàn)為化膿性炎和肉芽腫性炎;炎癥為混合炎細(xì)胞(中性粒細(xì)胞、漿細(xì)胞、淋巴細(xì)胞、巨噬細(xì)胞)浸潤,炎細(xì)胞中無嗜酸性粒細(xì)胞。2.16例HIV(-)的馬爾尼菲籃狀菌病患者皮損組織巨噬細(xì)胞CD163均表達(dá),7例CD86表達(dá)(43.75%),1例Arg-1表達(dá)(6.25%)。10例馬爾尼菲籃狀菌感染小鼠組織(皮膚、肝臟、肺臟、脾臟)均表達(dá)CD86、CD163、Arg-1。3.馬爾尼菲籃狀菌感染的人CD86/CD163的光密度比值中位數(shù)(四分位數(shù))為0.00(0.00,0.51),馬爾尼菲籃狀菌感染的小鼠組織中巨噬細(xì)胞CD86/CD163的光密度比值平均值為1.71±1.91,兩者比較差異有統(tǒng)計(jì)學(xué)意義(p0.05)。CD86陽性表達(dá)患者組外周血淋巴細(xì)胞計(jì)數(shù)平均值為3.01±0.94,CD86無表達(dá)患者組外周血淋巴細(xì)胞計(jì)數(shù)平均值為1.87±1.05,兩者比較差異有統(tǒng)計(jì)學(xué)意義(p0.05)。結(jié)論HIV(-)患者感染馬爾尼菲籃狀菌,皮損組織中巨噬細(xì)胞極化可能存在失平衡,巨噬細(xì)胞傾向于被誘導(dǎo)向M2型極化。
[Abstract]:Objective to analyze the relationship between macrophage polarization, histopathological changes and clinical manifestations in the infected tissues of Bacillus marneffei, and to explore the mechanism of immune defense of the host. Methods paraffin lumps were collected from 16 cases of HIV (-) and 10 cases of infected mice skin, lung, liver and spleen tissues from HIV (-) patients. HE staining was used to analyze the inflammatory response pattern of infected tissues and the expression of CD86,CD163,Arg-1 in macrophages was detected by immunohistochemical technique. The clinical data of 16 HIV (-) patients with Marnefi's disease were analyzed retrospectively and the relationship between macrophage polarization and clinical manifestations was analyzed. Results 1.The histopathological features of 16 cases of HIV (-) Marnefi's bacillariasis were suppurative inflammation in 10 cases (62.50%), suppurative inflammation with granulomatous inflammation in 5 cases (31.35%) and necrotizing inflammation in 1 case (6.25%). The inflammatory cells (neutrophils, eosinophils, plasma cells, lymphocytes, macrophages) infiltrated into the mixed inflammatory cells. The infection tissues of 10 mice showed suppurative inflammation and granulomatous inflammation. Inflammatory cells (neutrophilic granulocytes, plasma cells, lymphocytes, macrophages) infiltrated, and no eosinophilic granulocytes were found in the inflammatory cells. 2. The CD163 expression of macrophages in the lesions of patients with HIV (-) was observed. 7 cases (43.75%) expressed CD86, 1 case (6.25%) expressed Arg-1. 10 cases (skin, liver, lung, spleen) of mice infected with Bacillus marneffei expressed CD86,CD163,Arg-1.3.. The median optical density ratio (four quartiles) of human CD86/CD163 infected by Bacillus marneffei was 0.00 (0.000. 51). The average optical density ratio of CD86/CD163 in macrophages was 1.71 鹵1.91 in mice infected with Bacillus marneffei. There was a significant difference between the two groups (p0.05). The mean value of peripheral blood lymphocyte count in patients with CD86 positive expression was 3.01 鹵0.94 + CD86 and 1.87 鹵1.05 in patients without CD86 expression. The difference was statistically significant (p 0.05). Conclusion if HIV (-) patients are infected with Bacillus marneffei, the polarization of macrophages may be out of balance in the lesions, and macrophages tend to be induced to M2 polarization.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R519

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