NEJM:新冠肺炎患者肺部病理生物学特征研究

2020-07-09 MedSci原创 MedSci原创

与流感造成的急性呼吸窘迫,新冠肺炎患者存在毛细血管微血栓、微血管病变以及新血管生成等肺部病理生物学特征

渐进性呼吸衰竭是2019年冠状病毒病(Covid-19)最主要的死亡原因,但Covid-19死亡患者周围肺的相关形态学和分子水平的变化研究尚不充分。
 
研究人员获得7名Covid-19死亡患者的肺组织样本,并将10名死于甲型H1N1流感(H1N1)感染导致的急性呼吸窘迫综合征(ARDS)患者肺样本和10个年龄匹配的未感染肺样本进行了比较。采用七色免疫组化分析、显微计算机断层成像、扫描电子显微镜、基因表达等多重方法对肺组织差异进行了研究。
 
Covid-19相关或流感相关呼吸衰竭死亡患者中,周围肺的组织学模式是弥漫性肺泡损伤伴血管周围T细胞浸润。 Covid-19患者肺组织也表现出独特的血管特征,包括与细胞内病毒的存在和细胞膜破坏有关的严重内皮损伤。 对Covid-19患者肺血管的组织学分析显示存在广泛的血栓形成伴微血管病变。Covid-19患者肺泡毛细血管微血栓发生率是流感患者的9倍。在Covid-19患者的肺中,新血管的生成量是流感患者肺部的2.7倍。
 
研究发现,与流感造成的急性呼吸窘迫,新冠肺炎患者存在毛细血管微血栓、微血管病变以及新血管生成等肺部病理生物学特征。
 
原始出处:
 
Maximilian Ackermann et al. Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19. N Engl J Med, July 9, 2020.

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    2021-12-29 La lune

    Covid-19 and KD

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1085562, encodeId=1364108556274, content=Covid-19 and KD, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210807/42263cbb66164c32b770bc01ea00539b/70c807d61e6f44b3ae4cee58ddebe065.jpg, createdBy=912e2488233, createdName=La lune, createdTime=Wed Dec 29 20:59:11 CST 2021, time=2021-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1798538, encodeId=3be11e985389e, content=<a href='/topic/show?id=05fa6931862' target=_blank style='color:#2F92EE;'>#生物学特征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69318, encryptionId=05fa6931862, topicName=生物学特征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f34c147, createdName=ay2000fy, createdTime=Thu Nov 05 21:49:45 CST 2020, time=2020-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1617919, encodeId=3d14161e91901, content=<a href='/topic/show?id=e88f6930185' target=_blank style='color:#2F92EE;'>#生物学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69301, encryptionId=e88f6930185, topicName=生物学)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e44019811593, createdName=12498c32m74暂无昵称, createdTime=Sat Jul 11 09:49:45 CST 2020, time=2020-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=801969, encodeId=4bb180196985, content=<a href='/topic/show?id=30f04e8389a' target=_blank style='color:#2F92EE;'>#川崎病#</a>所以在儿童得了新冠肺炎感染,哪怕没有症状,过一段时间都可能会患上川崎样疾病,即多系统炎症综合症。, beContent=null, objectType=article, channel=null, level=null, likeNumber=161, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47838, encryptionId=30f04e8389a, topicName=川崎病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Jul 09 22:41:59 CST 2020, time=2020-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=801965, encodeId=f85e8019654b, content=<a href='/topic/show?id=46ce580e865' target=_blank style='color:#2F92EE;'>#新冠肺炎#</a>这个研究有力的证明,新冠肺炎是血管内皮细胞损伤导致的,所以他可能会导致全身性的损伤,损伤高度依赖血管内皮。, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58078, encryptionId=46ce580e865, topicName=新冠肺炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Jul 09 22:26:36 CST 2020, time=2020-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028274, encodeId=9c0910282e4e7, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Thu Jul 09 21:49:45 CST 2020, time=2020-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035340, encodeId=3b2c103534067, content=顶刊就是顶刊,谢谢williamhill asia 带来这么高水平的研究报道,williamhill asia 科里同事经常看williamhill asia ,分享williamhill asia 上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jul 09 21:49:45 CST 2020, time=2020-07-09, status=1, ipAttribution=)]
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    2020-07-09 lovetcm

    #川崎病#所以在儿童得了新冠肺炎感染,哪怕没有症状,过一段时间都可能会患上川崎样疾病,即多系统炎症综合症。

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1085562, encodeId=1364108556274, content=Covid-19 and KD, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210807/42263cbb66164c32b770bc01ea00539b/70c807d61e6f44b3ae4cee58ddebe065.jpg, createdBy=912e2488233, createdName=La lune, createdTime=Wed Dec 29 20:59:11 CST 2021, time=2021-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1798538, encodeId=3be11e985389e, content=<a href='/topic/show?id=05fa6931862' target=_blank style='color:#2F92EE;'>#生物学特征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69318, encryptionId=05fa6931862, topicName=生物学特征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f34c147, createdName=ay2000fy, createdTime=Thu Nov 05 21:49:45 CST 2020, time=2020-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1617919, encodeId=3d14161e91901, content=<a href='/topic/show?id=e88f6930185' target=_blank style='color:#2F92EE;'>#生物学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69301, encryptionId=e88f6930185, topicName=生物学)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e44019811593, createdName=12498c32m74暂无昵称, createdTime=Sat Jul 11 09:49:45 CST 2020, time=2020-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=801969, encodeId=4bb180196985, content=<a href='/topic/show?id=30f04e8389a' target=_blank style='color:#2F92EE;'>#川崎病#</a>所以在儿童得了新冠肺炎感染,哪怕没有症状,过一段时间都可能会患上川崎样疾病,即多系统炎症综合症。, beContent=null, objectType=article, channel=null, level=null, likeNumber=161, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47838, encryptionId=30f04e8389a, topicName=川崎病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Jul 09 22:41:59 CST 2020, time=2020-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=801965, encodeId=f85e8019654b, content=<a href='/topic/show?id=46ce580e865' target=_blank style='color:#2F92EE;'>#新冠肺炎#</a>这个研究有力的证明,新冠肺炎是血管内皮细胞损伤导致的,所以他可能会导致全身性的损伤,损伤高度依赖血管内皮。, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58078, encryptionId=46ce580e865, topicName=新冠肺炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Jul 09 22:26:36 CST 2020, time=2020-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028274, encodeId=9c0910282e4e7, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Thu Jul 09 21:49:45 CST 2020, time=2020-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035340, encodeId=3b2c103534067, content=顶刊就是顶刊,谢谢williamhill asia 带来这么高水平的研究报道,williamhill asia 科里同事经常看williamhill asia ,分享williamhill asia 上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jul 09 21:49:45 CST 2020, time=2020-07-09, status=1, ipAttribution=)]
    2020-07-09 lovetcm

    #新冠肺炎#这个研究有力的证明,新冠肺炎是血管内皮细胞损伤导致的,所以他可能会导致全身性的损伤,损伤高度依赖血管内皮。

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1085562, encodeId=1364108556274, content=Covid-19 and KD, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210807/42263cbb66164c32b770bc01ea00539b/70c807d61e6f44b3ae4cee58ddebe065.jpg, createdBy=912e2488233, createdName=La lune, createdTime=Wed Dec 29 20:59:11 CST 2021, time=2021-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1798538, encodeId=3be11e985389e, content=<a href='/topic/show?id=05fa6931862' target=_blank style='color:#2F92EE;'>#生物学特征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69318, encryptionId=05fa6931862, topicName=生物学特征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f34c147, createdName=ay2000fy, createdTime=Thu Nov 05 21:49:45 CST 2020, time=2020-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1617919, encodeId=3d14161e91901, content=<a href='/topic/show?id=e88f6930185' target=_blank style='color:#2F92EE;'>#生物学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69301, encryptionId=e88f6930185, topicName=生物学)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e44019811593, createdName=12498c32m74暂无昵称, createdTime=Sat Jul 11 09:49:45 CST 2020, time=2020-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=801969, encodeId=4bb180196985, content=<a href='/topic/show?id=30f04e8389a' target=_blank style='color:#2F92EE;'>#川崎病#</a>所以在儿童得了新冠肺炎感染,哪怕没有症状,过一段时间都可能会患上川崎样疾病,即多系统炎症综合症。, beContent=null, objectType=article, channel=null, level=null, likeNumber=161, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47838, encryptionId=30f04e8389a, topicName=川崎病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Jul 09 22:41:59 CST 2020, time=2020-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=801965, encodeId=f85e8019654b, content=<a href='/topic/show?id=46ce580e865' target=_blank style='color:#2F92EE;'>#新冠肺炎#</a>这个研究有力的证明,新冠肺炎是血管内皮细胞损伤导致的,所以他可能会导致全身性的损伤,损伤高度依赖血管内皮。, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58078, encryptionId=46ce580e865, topicName=新冠肺炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Jul 09 22:26:36 CST 2020, time=2020-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028274, encodeId=9c0910282e4e7, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Thu Jul 09 21:49:45 CST 2020, time=2020-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035340, encodeId=3b2c103534067, content=顶刊就是顶刊,谢谢williamhill asia 带来这么高水平的研究报道,williamhill asia 科里同事经常看williamhill asia ,分享williamhill asia 上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jul 09 21:49:45 CST 2020, time=2020-07-09, status=1, ipAttribution=)]
    2020-07-09 公卫新人

    新冠肺炎,疫情何时才能消失

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1085562, encodeId=1364108556274, content=Covid-19 and KD, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210807/42263cbb66164c32b770bc01ea00539b/70c807d61e6f44b3ae4cee58ddebe065.jpg, createdBy=912e2488233, createdName=La lune, createdTime=Wed Dec 29 20:59:11 CST 2021, time=2021-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1798538, encodeId=3be11e985389e, content=<a href='/topic/show?id=05fa6931862' target=_blank style='color:#2F92EE;'>#生物学特征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69318, encryptionId=05fa6931862, topicName=生物学特征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f34c147, createdName=ay2000fy, createdTime=Thu Nov 05 21:49:45 CST 2020, time=2020-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1617919, encodeId=3d14161e91901, content=<a href='/topic/show?id=e88f6930185' target=_blank style='color:#2F92EE;'>#生物学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69301, encryptionId=e88f6930185, topicName=生物学)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e44019811593, createdName=12498c32m74暂无昵称, createdTime=Sat Jul 11 09:49:45 CST 2020, time=2020-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=801969, encodeId=4bb180196985, content=<a href='/topic/show?id=30f04e8389a' target=_blank style='color:#2F92EE;'>#川崎病#</a>所以在儿童得了新冠肺炎感染,哪怕没有症状,过一段时间都可能会患上川崎样疾病,即多系统炎症综合症。, beContent=null, objectType=article, channel=null, level=null, likeNumber=161, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47838, encryptionId=30f04e8389a, topicName=川崎病)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Jul 09 22:41:59 CST 2020, time=2020-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=801965, encodeId=f85e8019654b, content=<a href='/topic/show?id=46ce580e865' target=_blank style='color:#2F92EE;'>#新冠肺炎#</a>这个研究有力的证明,新冠肺炎是血管内皮细胞损伤导致的,所以他可能会导致全身性的损伤,损伤高度依赖血管内皮。, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58078, encryptionId=46ce580e865, topicName=新冠肺炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Jul 09 22:26:36 CST 2020, time=2020-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028274, encodeId=9c0910282e4e7, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Thu Jul 09 21:49:45 CST 2020, time=2020-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035340, encodeId=3b2c103534067, content=顶刊就是顶刊,谢谢williamhill asia 带来这么高水平的研究报道,williamhill asia 科里同事经常看williamhill asia ,分享williamhill asia 上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jul 09 21:49:45 CST 2020, time=2020-07-09, status=1, ipAttribution=)]
    2020-07-09 旺医

    顶刊就是顶刊,谢谢williamhill asia 带来这么高水平的研究报道,williamhill asia 科里同事经常看williamhill asia ,分享williamhill asia 上的信息

    0

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