在COVID-19患者中,上皮层区域结构失调:危急疾病持续时间的影响
Tian-Zi Wen1, Wen-Juan Fu1, Shi-Qi Xiao1
1Institute of Pathology, Southwest Hospital, Third Military Medical University (Army Medical University), and Key Laboratory of Tumor Immunopathology, Ministry of Education of China, Chongqing, China.
Pathology, research and practice
|March 15, 2024
概括
COVID-19 破坏了上腺体结构,特别是在长期住院患者中. 这项研究揭示了上腺皮质的显著变化和皮质类固醇受体活性降低,突出显示了监测上腺功能的必要性.
科学领域:
- 内分泌学 在内分泌学.
- 病理学 病理学 病理学
- 在COVID-19研究研究中.
背景情况:
- 在COVID-19中注意到异常的上腺功能,但基因病理学数据很少.
- 了解疾病持续时间对上腺的影响至关重要.
研究的目的:
- 为了研究COVID-19持续时间对上腺结构和皮质类固醇反应性的影响.
- 为了提供COVID-19对上腺皮质影响的组织病理学证据.
主要方法:
- 对15名长时间ICU住院COVID-19,9名短时间ICU住院COVID-19患者和20名对照者的回顾性解剖研究.
- 排除之前接受过葡萄糖皮质激素治疗的患者.
- 血素和欧 (H&E) 和免疫组织化学 (IHC) 染色以分析上腺皮结构和核受体转位.
主要成果:
- COVID-19患者表现出不组织的上腺皮质结构,在长时间的ICU住院病例中,严重的不组织更为普遍 (67%对11%).
- 与对照组相比,上腺皮层的变化包括球状区域 (ZG) 减少了40%和带区域 (ZF) 增加了74%.
- 长时间的ICU住院患者表现出进一步的ZG减少 (31%) 和ZF扩张 (27%) 与短时间的ICU住院患者相比,肝脏和脏的皮质类固醇受体核转位明显较低 (≥43%).
结论:
- COVID-19显著改变了上腺结构,疾病持续时间加剧了这些变化.
- 长时间ICU住院的COVID-19患者表现出皮质类固醇受体信号受损.
- 对长期住院COVID-19患者来说,对上腺功能进行临床监测至关重要.
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