Abstract:

 Objective    To investigate possible immunopathogenesis of acute necrotizing encephalopathy （ANE） associated with 2009 influenza A （H1N1） virus through observing pathological changes in children brain tissues. Methods Three children died from ANE were included in this study. Hematoxylin—Eosin staining， myelin staining，microglia paraffin section staining and immunohistochemical EliVision method were performed， respectively. Results    Processus spinosus of microglia in brain tissues of ANE was observed to disappear and become round. Myelin staining confirmed that nerve fibers of central nervous system changed to demyelination. It was confirmed that microglia was activated in ANE by the Nao menke and Feigin staining method. Immunohistochemisty showed that activated microglia expressed TNF-α and IFN-α. No infiltration of lymphocytes and neutrophilic granulocyte were obseved in brain tissues of ANE chidren. Conclusions    The abnormal hyperplasia of microglia might be one of the pathogenesis involved in the ANE.

Key words: children, influenza A （H1N1）, acute necrotizing encephalopathy, cytokine

摘要：

 目的    通过观察3例儿童2009年新型甲型H1N1流感病毒急性坏死性脑病（ANE）脑组织病理性改变，探讨ANE脑组织可能的免疫病理反应。方法    对2009年11月至2010年1月深圳儿童医院3例因ANE死亡患儿脑组织行HE染色形态学观察、髓鞘染色、小胶质细胞石蜡切片染色及免疫组织化学EliVision法检测分析。结果    ANE患儿脑组织小胶质细胞棘突消失变为圆形，髓鞘染色证实脑实质神经纤维呈脱髓鞘改变，经Nao menke 及Feigin染色法证实小胶质细胞处于激活状态，免疫组化发现ANE患儿小胶质细胞产生TNF-α和IFN-α，脑组织未见淋巴细胞、中性粒细胞浸润。结论    小胶质细胞异常增生可能是导致ANE发病的原因之一。

关键词: 儿童, 甲型H1N1流感, 急性坏死性脑病, 细胞因子