破裂人脑囊性动脉瘤的组织病理学及结构变化

The tissue pathology and structure change in human cerebal saccular aneurysm

目的观察破裂人脑囊性动脉瘤的组织病理学及结构变化。方法对34例破裂人脑囊性动脉瘤和10例对照组动脉标本进行肉眼大体观察及光镜观察。结果①肉眼大体观察:本组患者动脉瘤部分可见动脉粥样硬化斑块;部分动脉瘤瘤腔内有血栓附着;②光镜观察:a.苏木精-伊红染色:所有动脉瘤壁的三层结构均已经部分或全部破坏,管壁结构异常。动脉瘤管壁厚薄明显不均;中膜和外膜可见大量的炎性细胞浸润;部分动脉瘤腔内充满血栓,有的血栓已经纤维化,血栓基部机化。b.弹力纤维染色:脑动脉瘤壁内弹力膜几乎完全消失。对照组动脉壁的内弹力膜完整,胶原纤维排列整齐。结论人脑囊性动脉瘤壁的组织病理学及结构改变主要是动脉瘤壁内弹力膜和弹力纤维的破坏或消失,胶原纤维溶解,平滑肌细胞减少或消失,炎性细胞侵润,导致动脉瘤壁基质结构的严重破坏,抗张力强度降低。

Objective To observe the tissue pathology and structure change in human cerebal saccular aneurysm.Methods To observe the all spieimens with naked eyes and lightscope. Results ① Naked eyes obervation：Atherosclerosis plaques could be seen in some of the aneurysmal specimens .There were thrombosis in some cavities of the aneurysms. ②Lightscope observation ：a. HE staining： All three elements of the aneurysmal wall were damaged totally or partially.The wall of the vessels were abnormal.The thickness of aneurysreal wall was various, the all layers or local region became thin and extended outside .The massive inflammatory cells invaded the middle and external layer. Some cavities were full of thrombosis. Some thrombosis was fibrosis, the bottom was organization, b. Elatie fibrila staining： the internal elastic menbrane almost completely disappeared. Conclusion The main chang in human eerebal saccular aneurysm lies in the damage or dissappear if the internal elastidmenbrane and elastic fibrils, the dissoving of collagen fibrils, the decreasing or dissappeared soomth muscle cells, the inflammatory cells invasion, which leads to the severe damage of matrix layers, decreased the resistant tension.