董海艷《醫(yī)學(xué)微生物學(xué)》第10章 分枝桿菌屬ppt課件

1、醫(yī)學(xué)微生物與免疫學(xué)教研室醫(yī)學(xué)微生物與免疫學(xué)教研室 董海艷董海艷 俗稱結(jié)核桿菌俗稱結(jié)核桿菌tubercle bacillustubercle bacillus 是人類結(jié)核病的病原菌是人類結(jié)核病的病原菌1 1、形狀染色、形狀染色mycobacteria結(jié)核桿菌結(jié)核桿菌acid-fast stain莢膜莢膜與細(xì)胞外表受體結(jié)合粘附與入侵細(xì)胞與細(xì)胞外表受體結(jié)合粘附與入侵細(xì)胞含多種酶分解利用營養(yǎng)物質(zhì)含多種酶分解利用營養(yǎng)物質(zhì)維護(hù)防止有害物質(zhì)的進(jìn)入菌體維護(hù)防止有害物質(zhì)的進(jìn)入菌體 抑制吞噬體與溶酶體交融抑制吞噬體與溶酶體交融脂質(zhì)脂質(zhì)索狀因子破壞線粒體，抑制中性粒細(xì)胞索狀因子破壞線粒體，抑制中性粒細(xì)胞,引起肉芽腫

2、引起肉芽腫蠟質(zhì)蠟質(zhì)D D引起遲發(fā)性過敏反響引起遲發(fā)性過敏反響硫酸腦苷脂抑制吞噬體與溶酶體結(jié)合硫酸腦苷脂抑制吞噬體與溶酶體結(jié)合蛋白質(zhì)蛋白質(zhì)即結(jié)核菌素，引起遲發(fā)性過敏反響即結(jié)核菌素，引起遲發(fā)性過敏反響致病物質(zhì)致病物質(zhì)磷脂刺激單核細(xì)胞增生，構(gòu)成結(jié)核結(jié)節(jié)磷脂刺激單核細(xì)胞增生，構(gòu)成結(jié)核結(jié)節(jié)Chest X-ray of severe pulmonary tuberculosis patient 以前感染過或免疫豚鼠以前感染過或免疫豚鼠正常豚鼠正常豚鼠24-48小時小時10-14天天部分紅腫、淺潰瘍部分紅腫、淺潰瘍部分紅腫、潰瘍部分紅腫、潰瘍 不分散，不分散，零落后自行愈合零落后自行愈合壞死，經(jīng)久不愈壞死，

3、經(jīng)久不愈有毒有毒TB菌菌全身分散全身分散皮下皮下郭霍景象郭霍景象A TB skin test is typically performed on the forearm. After sterilizing the skin, a measured amount of PPD is injected intracutaneously.Within 48 to 72 hours, a positive TB skin test is marked by an area of reddish induration greater than 10 mm. It is the induration (firm bump) that is gently palpated that determines the size, not the area of redness. This reaction is slightly larger than the average positive test