中文摘要：

目的 分析肠道病毒71型（EV71）感染死亡病例肺、脑及脊髓病理改变,并检测清道夫受体B族2型（SCARB2）的表达.方法 以9例EV71感染死亡病例（即EV71组）临床资料及肺、脑和脊髓组织为研究对象,7例意外死亡病例作为对照.HE染色观察病理改变,免疫组织化学检测SCARB2的表达,图像分析软件检测阳性积分光密度（IOD）值.结果 9例病例均出现发热、呕吐、惊跳、抖动、嗜睡等表现及肺水肿X线征象;9例病例肺均显示淤血、广泛水肿伴肺泡壁炎性细胞浸润,1例肺泡腔内透明膜形成;脑组织淋巴细胞围绕血管呈袖套状浸润,神经细胞变性坏死;7例脑干、3例大脑及3例脊髓出现筛状软化灶,卫星及噬神经现象,胶质小结等.免疫组织化学显示SCARB2在EV71组和对照组均阳性;EV71组和对照组病例肺IOD值分别为4.15×105、0.05×105,差异有统计学意义（t=108.00,P＜0.01）;脑IOD值分别为2.85×105、0.13×105,差异有统计学意义（t=108.00,P＜0.01）.SCARB2在EV71组大脑、脑干及脊髓中IOD值分别为2.24×105、3.65×105、3.95×105,大脑与脑干、脊髓之间比较差异有统计学意义（P均＜0.01）,而脑干与脊髓之间差异无统计学意义（P＞0.05）.结论 EV71感染后主要死于严重的脑炎、脑干脑炎和神经源性肺水肿.EV71感染严重程度及其嗜神经性可能与SCARB2的高表达相关.

英文摘要：

Objective To analyze the clinical data,pathological features,and explore the expression of scavenger receptor class B member 2 （SCARB2） of the lung,brain and spinal cord in 9 cases infected with enterovirus71 （EV71）.Methods The lung,brain and spinal cord tissues and clinical data of 9 cases infected with EV71 （EV71 group） were selected as research group,7 cases who died of accidents were selected as control group.The pathological features were observed by way of hematoxylin and eosin（HE） staining,and the expression of SCARB2 was tested by immunohistochemistry,the integrated optical density （IOD） was detected by using picture analysis software.Results Nine cases had fever,vomiting,startle response,shake,fatigue and pulmonary edema in chest X ray; Congestion,extensive edema and inflammatory cells infiltration in alveolar walls were found in lungs of 9 cases.Transparent membrane was seen obviously in alveolar lumen in 1 case.The brain showed degeneration and necrosis of nerve cells and perivascular cuffing of lymphocytes.Brainstem in 7 cases,brain and spinal cord in 3 cases both revealed cribriform softened,satellitism and neuronophagia,glial nodule.Immunohistochemistry results showed that SCARB2 in EV71 group and the control group were both positive,as the lung tissue IOD values in EV71 group and control group were 4.15 × 105 and 0.05 × 105,there was significant difference between the 2 groups（t =108.00,P 〈 0.01）.The brain tissue IOD values were 2.85 × 105 and 0.13 × 105,there was significant difference between the 2 groups （t =108.00,P 〈 0.01） ; The IOD of SCARB2 in brain,brainstem and spinal cord in EV71 group were 2.24 × 105,3.65 × 105,3.95 × 105,respectively.The differences between brain and brainstem,or brain and spinal cord were both statistically significant （all P 〈 0.01）,but there was no statistically significant difference between brainstem and spinal cord （P 〉 0.05）.Conclusions The patients mainly died of severe encephalitis,brainstem encephalitis and ne