淀粉样脑血管病26例尸检标本免疫组化病理研究  

Immunohistochemical Study of 26 Autopsy Cases of Cerebral Amyloid Angiopathy

作　　者：李晓秋[1] 周中和[1] 徐慧琴[1] 王耀山[1] 陈会生[1] 

机构地区：[1]沈阳军区总医院神经内科,沈阳110840

出　　处：《解放军医药杂志》2014年第4期20-23,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：辽宁省博士启动基金(20121088)

摘　　要：目的探讨β淀粉样蛋白(Aβ1-40、Aβ1-42)、β淀粉样蛋白前体蛋白(β-amyloid precursor protein,βAPP)以及半胱氨酸蛋白酶抑制剂C(Cystatin C,CC)在淀粉样脑血管病(cerebral amyloid angiopathy,CAA)脑组织中的表达情况。方法采用免疫组化方法,检测26例CAA患者尸检脑组织中Aβ1-40、Aβ1-42、βAPP和CC的表达情况。结果 Aβ1-40表达广泛见于枕叶、颞叶、顶叶、额叶,Aβ1-42、βAPP表达可见于颞叶、枕叶和顶叶,CC表达仅见于1例顶叶和枕叶;Aβ1-40、Aβ1-42、βAPP染色阳性主要见于中、小血管的血管壁外层,CC染色阳性多见于血管壁外膜,均可见脑血管壁增厚,透明样变性。结论 Aβ1-40是CAA血管壁内沉积淀粉样蛋白的主要成分,在CAA发生机制中起重要作用,并为CAA治疗目标Aβ从血管的靶向清除提供指导意义。Objective To evaluate the expressions of Aβ1-40, Aβ1-42, β-amyloid precursor protein（βAPP） and Cystatin C （CC） in the brain issues of cerebral amyloid angiopathy （CAA）. Methods Expressions of Aβ1-40, Aβ1-42, βAPP and CC in the brain samples of 26 autopsy cases of CAA were detected by immunohistochemical method. Results The Aβ1-40 expression in vessel wall widely existed in occipital, temporal ,parietal and frontal lobes, expres- sions of Aβ1-42 and βAPP existed in temporal, occipital and parietal lobes, and CC expression existed in parietal and oc- cipital lobes of one case; positive stainings of Aβ1-40, Aβ1-42 and βAPP were mainly existed in the medium-sized and small-sized vascular outer layer of vessel walls, positive staining of CC mainly existed in the outer membrane of the vessel walls. At the same time, thickening and hyaloid degeneration of cerebral vessel wall were also found. Conclusion Aβ1- 40 is the main component of amyloid-laden vessel walls, and it has important implications for the pathogenesis of CAA, which may provide therapy guidance for targeting Aβ to be cleared from blood vessels.

关 键 词：淀粉样脑血管病 淀粉样蛋白 半胱氨酸蛋白酶抑制剂C 淀粉样蛋白前体蛋白 脑出血 尸体解剖 

分 类 号：R743.9[医药卫生—神经病学与精神病学]