Alzheimer型老年性痴呆膝前区的病理改变

Pathological changes of the anterogenual region in senile dementia of Alzheimer type

用Ｇａｌｌｙａｓ和Ｃａｍｐｂｅｌｌ镀银技术研究了８例Ａｌｚｈｅｉｍｅｒ型老年性痴呆（ＳＤＡＴ）和８例同年龄正常对照的膝前区的病理学改变。在Ｇａｌｌｙａｓ染色的切片中大量或中等量的细胞内病理改变出现在痴呆个体的膝前区中，而非痴呆个体的膝前区中几乎没有病理学改变，最高密度的老年斑和神经原纤维缠结分别出现在膝前区的简单部（Ａｇｓ）、巨细胞部（Ａｇｍ）和膝旁部（Ｐｇ）的层Ⅲ和层Ⅴ中，神经原纤维缠结绝大多数出现在普通锥体细胞中，但偶尔可出现在Ａｇｍ层Ｖｂ的Ｂｅｔｚ细胞和层Ⅵ的非锥体细胞中。在Ｃａｍｐｂｅｌｌ染色的切片中，所有的痴呆病例和一个非痴呆个体的膝前区中出现了大量的淀粉样蛋白沉着，最高密度的淀粉样蛋白沉着出现在Ａｇｓ、Ａｇｍ和Ｐｇ的层Ⅲ中，Ｃａｍｐｂｅｌｌ嗜银物质的沉着显示了区域和板层的特异性。

Gallyas and Campbell-silver impregnation techniques were used to study the pathology of anterogenual regions collected from 8 cases with senile dementia of Alzheimer type and compared with 8 age-matched controls. Gallyas preparation showed a large or medium amount of intracellular pathological changes in anterogenual cortex of dementiated cases. The same regions of non-dementiated cases were free of neurofibrillary changes. The highest packing density of neuritic plaques and neurofibrillary tangles were observed in the layerⅢ and Va of area anterogenualis simple(Ags), area anterogenualis magnogagliongaglionalis(Agm) and paragenualis(Pg) respectively. Neurofibrillary tangles occurred mostly in typical pyramidal cells, but relatively uncommon in Betz cells of layer Vb and in non-pyramidal cells of layer VI of Agm. Campbell preparations showed a number of amyloid deposits in all cases examined. The highest packing densities of amyloid were seen in layer Ⅲ of Ags, Agm and Pg. The packing of Campbell-argyrophilic material showed area-specific and lamina-spicific distributions.