燃煤型砷中毒所致神经肌肉损害的临床病理观察  

Clinical pathological investigation of neuromuscular impairment by coal-burning arsenism

作　　者：刘桂成[1] 石国华[1] 田其豹[1] 李建萍[1] 任喻江[1] 

机构地区：[1]解放军第44医院特检科,贵阳550009

出　　处：《中国地方病学杂志》2006年第1期83-85,共3页Chinese Jouranl of Endemiology

基　　金：全军"十五"面上基金A类资助项目(01MA048)

摘　　要：目的探讨燃煤型砷中毒所致神经肌肉损害的临床病理特征。方法对4例中、重度燃煤型砷中毒患者的腓肠神经与腓肠肌进行活检,光镜与电镜观察周围神经与肌肉的病理变化。结果光镜下见神经纤维变性萎缩,部分区域呈现脱髓鞘改变,间质中未见炎症细胞浸润;骨骼肌呈现节段性凝固性坏死(蜡样坏死),肌肉中未见炎症细胞浸润。电镜下见有髓神经纤维,部分有髓鞘分层、溶解塌陷,髓鞘下可见大空泡,轴浆内结构基本正常,部分血旺氏细胞轻度肿胀;肌丝灶性溶解,肌膜呈城垛样改变,T小管增多,肌细胞部分发生萎缩,间质增多。结论燃煤型砷中毒可致周围神经、肌肉病理改变,从而导致一系列临床症状,并引起功能障碍。Objective To research the clinical pathological characters of neuromuscular impairment by coal-burnt arsenism. Methods Gastrocnemius muscle and sural nerve biopsy were made in 4 patients with middle or severe coal-burning arsenism. Nervous or muscular pathological changes were observed under light and electron microscope. Results Under light microscope , degenerative atrophy and demyelination were shown in nerve fibers without inflammatory cell infiltration in stroma; segmental coagulation necrosis was found in skeletal muscles with no inflammatory cell infiltration. Under electromicroscope, lamination and lysis of myelinated sheave, and vacuole formation were seen in some myelinated nerve fibers. Some Schwann cell swelled slightly. Myofilament focal lysis, segmental sarcolemma, increased T-tubule and stroma, and even some myocyte atrophy were found. Conclusions Coal-burning arsenism may result in peripheral nerve and muscle impairment.

关 键 词：煤 砷中毒 神经肌肉表现 病理学 临床 

分 类 号：R599[医药卫生—内科学]