Gallyas-Braak银染法在神经系统变性疾病中的应用  

The application of Gallyas-Braak stainings in pathologic diagnosis of neurodegenerative diseases

作　　者：王鲁宁[1] 朱明伟[1] 李向红[2] 桂秋萍[2] 

机构地区：[1]解放军总医院南楼神经科,北京100853 [2]解放军总医院南楼病理科,北京100853

出　　处：《中华内科杂志》2002年第2期120-123,共4页Chinese Journal of Internal Medicine

基　　金：国家 973资助项目 (G2 0 0 0 0 5 70 )

摘　　要：目的　评估Gallyas Braak银染色方法在几种神经系统变性疾病病理诊断中的作用和价值。方法　采用修订Gallyas Braak染色法 ,对经临床和常规病理方法诊断的 2 2例神经系统变性病的脑和脊髓标本进行了回顾性研究。结果　Gallyas Braak银染色可良好显示Alzheimer病 (AD) ,其他变性病痴呆 ,正常老年人的海马及额、颞叶皮层神经原纤维缠结 ,且较Bodian染色清楚。在 4例有痴呆症状和明显锥体外体征患者的中脑 ,基底节观察到大量神经元球形团样缠结 ,同时在运动皮层 ,基底节 ,中脑观察到星形细胞丛状缠结 ,其中 2例符合进行性核上性麻痹的病理诊断标准 ,另 2例观察到运动皮层和基底节区星形细胞斑 ,加之皮层神经元气球样变 ,符合皮质基底节变性的病理特征。 3例多系统萎缩的脑和脊髓白质显示广泛分布少突胶质细胞包涵体。 1例AD病的颞叶和海马皮质 2～ 3层神经毡内显示嗜银颗粒 ,而Bodian染色未观察到这些病理改变。结论　Gallyas Braak染色除显示神经原纤维缠结外 ,还能较好显示胶质细胞变性和神经毡异常结构 ,因此对进行性核上性麻痹 ,皮质基底节变性 ,多系统萎缩 。Objective To evaluate the role of Gallyas silver staining in the diagnosis of neurodegenerative diseases. Method Modified Gallyas-Braak staining method was used to investigate samples of the brain and spinal cord of 22 cases with neurodegenerative disease including Alzheimer′s disease(AD) ,Parkinson′s diseas (PD),Pick′s disease, diffuse Lewy body disease(DLBD), progressive supranuclear palsy(PSP) , diagnosed by clinical and routine pathologic method. 10 cases without clinical symptoms and pathologic abnormalities of the nervous system served as control. Result As compared with Bodian staining, Gallyas-Braak staining demonstrated clearly neurofibrillary tangles in the hippocampus and the cortex of frontal and temperal lobe in all the cases with Alzheimer′s disease,6 cases with dementia of other causes and 3 normal aged. However, global neurofibrillary tangles in the midbrain and the basal ganglia were found only with Gallyas-Braak staining in 4 cases with both dementia and extrapyramidal features. In addition, tuft-shaped astrocytes were shown with this method in the motor cortex ,basal ganglia, midbrain of the above 4 cases and astrocytic plaques in the same area in 2 cases of the 4 cases. In this connexion, pathologic findings in 2 of the 4 cases corresponded to PSP and those of the other two cases fufiled the diagnostic criteria of corticobasal degeneration(CBD) Oligodendroglial cytoplasmic inclusions in the white matter of the brain and the spinal cord were founded in 3 of the 4 cases with multiple system atrophy(MSA). This silver staining demonstrated as well a lot of argyrophilic grains in the neuropil of the temporal lobe and the hippocampus in one case with AD. Conclusion Gallyas silver staining could better reveal not only Alzheimer-like neurofibrillary tangles but also different glial inclusions in other neurodegenerative diseases such as PSP, CBD and MSA. Consequently, it is of great value in the pathologic diagnosis and study of such degenerative diseases.

关 键 词：病理学 神经变性疾病 Gallyas-Braak染色 诊断 

分 类 号：R741.04[医药卫生—神经病学与精神病学]