精神分裂症患者外科治疗与病理变化及预后的研究

Study of surgical treatment,pathologic variation and prognosis in patients with schizophrenia

目的探讨精神分裂症患者手术切除的脑组织病理变化和了解该病的预后。方法对6例药物难治性精神分裂症患者选择脑组织手术治疗,手术前患者全作脑CT和/或MRI影像学检查;不同脑部位靶点的脑组织作光镜和电镜的观察。结果精神病患者脑组织靶点出现神经细胞损害脱失和空泡变性,神经元纤维嗜银性增强,髓鞘脱失,星形细胞结节状增生,毛细血管增生,胆碱酯酶活性增强,酸性磷酸酶活性降低,神经细胞电子密度增加,线粒体扩张,溶酶体和脂褐素颗粒增加,中枢性髓鞘全部或节段性松散化,血管内皮细胞增生。结论精神分裂症患者脑组织通过形态学观察后并非为功能性,而是有脑组织结构异常,外科手术切除靶点的脑组织对治疗精神分裂症有重要价值。

Objective It is to discuss the pathologic change of brain tissues in schizophrenia after surgical treatment and to comprehend the prognosis of this disease, Methods Six patients with medicine intractable schizophrenia chose brain tissue operation treatment. Before operation, all of the patients took CT and/or MRI examination. The different targets from brain tissue were observed with microscope and electron microscope. Results There were nerve cell damaged or lost and vacuolar de- generation, neurofibril argyrophilia enhanced, myelin sheath lost, stellate cells nodosity hy-perplasia, blood capillary hyperplasia, cholinesterase activity enhanced, acid phosphatase activity lowered, nerve cell electron density increased, mitochondrion dilataltion, lysosome and lipofuscin particle increased, central myeline sheath in toto or segment loosed, and vascular endothelial cell hyperplasia in the brain tissue targets in schizophrenia patients. Conclusion The brain tissue changes of schizophrenia are not functional but structure abnormality through morphology observation. It is very important that schizophrenia patients take surgical treatment to cut brain tissue targets.