颞叶癫痫患者海马苔藓纤维发芽的实验研究  

Experimental study on mossy fiber sprouting in hippocampus of patients with temporal lobe epilepsy

作　　者：王娆[1] 杨志军[1] 杨顺海 徐如祥[1] 樊娟[1] 刘智良[1] 姜晓丹[1] 马宏伟[1] 李安民[3] 梁树立[3] 蔡颖谦[1] 杜谋选[1] 邹雨汐[1] 

机构地区：[1]南方大学珠江医院神经外科,广州510282 [2]河北省涿州市妇幼保健院儿科,072750 [3]解放军总医院附属第一医院神经外科,北京100853

出　　处：《中华神经医学杂志》2007年第5期460-463,共4页Chinese Journal of Neuromedicine

基　　金：国家自然科学基金(30400464;30672167);广东省名医工程研究项目(粤卫[2004]199号);广东省科技计划项目(2006B36004013);广州市科技计划项目(2006Z3-E5221)

摘　　要：目的观察颞叶癫痫病人海马齿状同和CA3区苔藓纤维出芽情况。方法癫痫组样本来自12例颢叶癫痫病例的手术切除标本包含海马齿状回和CA3区的脑组织,对照组脑组织样本来自4例非癫痫病的尸检脑组织。应用Timm组织化学染色方法在光镜和电镜水平进行海马结构苔藓纤维发芽的研究。结果光镜下癫痫组可见苔藓纤维穿越海马齿状同颗粒细胞层到达内分子层,CA3区也可见明显的苔藓纤维发芽。癫痫组CA3区和齿状同内分子层苔藓纤维发芽评分高于对照组,统计学上差异有显著性意义。电子显微镜下观察显示癫痫组患者齿状回内分子层可见到银标记的突触末端,主要和树突形成突触连接,所形成的突触为非对称性突触。结论颞叶癫痫可致海马齿状同和CA3区苔藓纤维发芽增加,这可能是难治性癫痫形成的重要机制。Objective To observe the mossy fiber sprouting in the resected hippocampal dentate gyrus and CA3 area of patients with temporal lobe epilepsy. Methods In epileptic group, the brain tissues including dentate gyrus and CA3 area of hippocampus were obtained by operation in 12 patients with temporal lobe epilepsy. In control group, the brain tissues were obtained from the autopsy on 4 dead patients without epilepsy. Hippocampal mossy fiber sprouting was observed by Timm＇s staining under light microscope and electron microscope. Results Under light microscope, it was found that hippocampal mossy fiber sprouted from granular cell layer into the inner molecular layer of dentate gyrus in epileptic group. Robust sprouting of mossy fibers was also seen in CA3 area of hippocampus. Compared with control group, the scores for mossy fiber sprouting of CA3 area and inner molecular layer of the dentate gyrus in epileptic group were higher, and the difference was significant statistically. Under electron microscope, many silver-labeled synaptic terminals could be found in inner molecular layer of the dentate gyrus and most of them commonly formed asymmetric synapse with dendrites in epileptic group. Conclusion Temporal lobe epilepsy can considerably promote mossy fiber sprouting. Mossy fiber sprouting in hippocampus may play an important role in the pathogenesis of intractable epilepsy.

关 键 词：颞叶癫痫 海马 苔藓纤维发芽 

分 类 号：R742.1[医药卫生—神经病学与精神病学]