海洛因海绵状白质脑病的病理学改变  

Pathological changes of heroin spongiform leukoencephalopathy

作　　者：石铸[1] 肖卫民[1] 潘速跃[2] 周亮[2] 陆兵勋[2] 

机构地区：[1]东莞市人民医院神经内科,523018 [2]南方医科大学南方医院神经内科

出　　处：《临床神经病学杂志》2010年第6期405-407,共3页Journal of Clinical Neurology

基　　金：中国博士后科学基金(2004036508);广东省卫生厅科技项目(B2008164)

摘　　要：目的研究海洛因海绵状白质脑病(HSLE)的病理学改变。方法应用常规染色和免疫组化染色(MBP、GFAP、NF、CD45、CD54、CD20)方法对3例HSLE死亡患者的脑组织进行病理检查。结果 HSLE的病理改变以脑白质海绵状变性为主,灰质很少受累。脑组织受累程度依次为小脑半球白质、内囊后肢、胼胝体压部、脑干、顶枕叶深部白质以及额颞叶深部白质,皮质以及皮质下弓状纤维不受累或仅轻微受累。HSLE白质损害以粗大的有髓神经纤维为主,髓鞘的损害重于轴突损害;脑组织无炎症细胞浸润,血管内亦无炎症介质沉积。结论脑白质广泛海绵状白质变性是HSLE显著的病理学特点,不同部位脑白质损害程度与临床和影像学表现一致,轴突损害可能继发于髓鞘损害,HSLE脑组织中无血管炎性改变。Objective To investigate the pathological changes of heroin spongiform leukoencephalopathy（HSLE）.Methods The brain tissue of 3 dead HSLE patients were pathological examinated by methods of normal and immunohistochemical staining（MBP,GFAP,NF,CD45,CD54,CD20）.Results The main pathological changes of HSLE were spongy degeneration of white matter,while the grey matter usually was not involved.The severity was in sequence of the white matter cerebellar hemisphere,posterior limbs of internal capsule,splenium of corpus calllosum,brain stem,deep white matter of occipital and parietal lobes.The arcuate fibers in cortical and subcortical were not involved or damaged slightly.The damage of white matter was the thick myelinated neural fibers mostly,and the damage of myelin sheaths was more severity than axon.Additionally,there was no sign of inflammatory medium congregating and inflammatory cells infiltrating in related area.Conclusions The pathological features of HSLE are spongiform vacuolar degeneration of white matter.The pathological lesions of various brain structures are coincident with clinical manifestation and radiological results.Axon impairment may take place secondary to demyelination.There is no vasculitic pathological change in the HSLE brain tissu.

关 键 词：海洛因海绵状白质脑病 病理 

分 类 号：R742.89[医药卫生—神经病学与精神病学]