淀粉样脑血管病患者的脑血管炎症反应及其临床特点  

Cerebral vascular inflammation reaction and its clinical features in patients with cerebral amyloid angiopathy

作　　者：李晓秋[1] 苏东风 王耀山[1] 徐慧琴[1] 

机构地区：[1]沈阳军区总医院神经内科,110016 [2]解放军第463医院神经内科

出　　处：《临床神经病学杂志》2013年第2期90-93,共4页Journal of Clinical Neurology

摘　　要：目的探讨淀粉样脑血管病(CAA)患者的脑血管炎症反应及其临床特点。方法 26例尸检CAA患者的脑标本作常规染色检查,调查、分析其临床资料;并对常规染色检查示有脑血管炎症反应的CAA患者的脑标本进行CD3、CD4、CD8、CD20、CD68单克隆抗体免疫组化染色。结果 4例患者(15.4%)有血管周围淋巴细胞浸润,脑血管炎症反应;22例患者无脑血管炎症反应。与无脑血管炎症反应组比较,脑血管炎症反应组的糖尿病、高血压、头痛、痫性发作、CSF蛋白含量高及脑白质病变的比率显著增高(均P<0.05)。脑血管炎症反应患者的脑组织CD4染色均阳性,CD3、CD8染色阳性各2例,CD20和CD68染色均阴性。结论CAA患者可合并脑血管炎症反应,其临床特点有头痛、痫性发作、CSF蛋白含量高和脑白质病变;可能为一个CAA合并脑血管炎症的征候群。Objective To explore the cerebral vascular inflammation reaction and its clinical features in patients with cerebral amyloid angiopathy （CAA）. Methods The brain specimens of 26 autopsy CAA patients were examined by conventional stained. Their clinical data were investigated and analyzed. And the brain specimens of CAA patients with cerebral vascular inflammation reaction were detected by CD3, CIM, CD8, CD20, CD68 monoclonal antibody immunohistochemical staining. Results There were 4 patients （ 15.4% ） with lymph ceils infiltrated around vessels, the cerebral vascular was inflammation reaction; 22 patients had no cerebral vascular inflammation reaction. Compared with no cerebral vascular inflammation reaction group, the rates of diabetes mellitus, hypertension, headache, seizures, CSF high protein content and brain white matter lesions were significantly increased in cerebral vascular inflammation reaction group （ all P 〈 0.05 ）. The CIM staining of brain tissue was all positive in 4 patients with cerebral vascular inflammation reaction, and the CD3, CD8 staining was positive in 2 eases respectively; the CD20 and CD68 staining were all negative. Conclusion CAA patients can complicate with cerebral vascular inflammatory reaction. Their clinical features are headache, seizures, CSF high protein content and leukoencephalopathy. That may be a syndromes of CAA combined with cerebral vascular inflammation.

关 键 词：淀粉样脑血管病 炎症 临床表现 

分 类 号：R743.3[医药卫生—神经病学与精神病学]