散发性脑炎的病理诊断及病因探讨

Pathological diagnosis and etiological analysis of spo radic encephalitis.

本文报告19例临床诊断为散发性脑炎的脑组织活检病理材料。15例病理变化主要表现为神经元不同程度的变性、坏死,有嗜元现象,胶质细胞增生,大部分可见胶质结节淋巴、单核细胞形成管周浸润,部分有小片状出血。4例仅见白质髓鞘脱失及水肿。上述结果表明:本组病例病理改变多数(79％)具有病毒性脑炎的特征,少数(21％)具有变态反应性脱髓鞘性脑炎的特征。作者认为脑组织活检可作为诊断本病的有效手段,并有助于明确病因。

This paper described the pathological changes of 19 cases with sporadic encephaLitis from brain biopsies. Degenerative changes of nerve cells and petechiai haemorrhges were seen in 15 cases. Small vessels exhibited perivascular cuffs of lymphocytes and mononuclear cells, and microgilai proliferation were noted. Pathological features mentioned above conformed to the characteristics of virus encephalitis. In 4 cases demyelination loci and edema in the white matter were foumd and conformed to the characteristics of allergic encephalitis. Etiology and diagnostic role of brain biopsy are discussed in these cases.