吸食海洛因患者海绵状白质脑病病理改变及其机制(附4例报告)  

Pathological analysis of heroin spongiform leukoencephalopathy: 4 cases report

作　　者：尹恝[1] 陆兵勋[1] 周亮[1] 吕田明[1] 陈强[1] 罗一峰[1] 潘速跃[1] 

机构地区：[1]南方医科大学南方医院神经内科,广东广州510515

出　　处：《第四军医大学学报》2007年第15期1415-1417,共3页Journal of the Fourth Military Medical University

基　　金：国家自然科学基金(30040038)

摘　　要：目的:分析吸食海洛因患者海绵状白质脑病(HSLE)的病理特征,探讨其白质病变的病理机制.方法:通过对4例HSLE脑尸检组织进行HE染色、Loyez染色、Bielschowsky's神经纤维染色及GFAP免疫组化染色,观察其组织学特点并进行分析.结果:HSLE病灶局限于白质,表现为对称性的大量的海绵状空泡形成,由皮质下白质向深层白质逐渐增多、增大;轴索改变轻于髓鞘,无神经细胞变性、坏死,星型胶质细胞无改变,无血管周围炎性细胞浸润.结论:原发性的髓鞘损害、磷脂脱失导致HSLE的脑白质海绵状空泡形成,其病理机制可能是由于海洛因的掺杂物中存在一种亲脂性的神经毒物进入CNS导致原发性的中毒性髓鞘病变.AIM： To study the pathological characteristics of the spongiform leukoencephalopathy in heroin addicts （HSLE）. METHODS ： Four cases of HSLE were enrolled in the study. HE staining, Loyez staining, Bielschowsky＇s staining, and GFAP im munohistochemical staining were carried out. RESULTS： Sym metric spongiform vacuolar degeneration was found in the white matter, and the lesions were more extensive in the deeper tissue. Compared with the myelin sheath, the axons were damaged mildly without neuron degeneration and necrosis, abnormity of astrocyte, or lymphocyte infiltration in the periphery of small vessels. CON CLUSION： Vacuolar degeneration in HSLE is caused by primary damage of the myelin sheath and phospholipids loss, probably due to lipophilic impurity of the heroin.

关 键 词：海洛因海绵状白质脑病 病理学 海绵状空泡变性 神经毒物 

分 类 号：R454.2[医药卫生—治疗学]