脑瘫患者脊神经根病变与临床关系探讨

The pathological changes of spinal nerve roots in patients with cerebral palsy and clinicopathologic relationship

对２０例脑瘫患者脊神经根光镜及透射电镜的病理形态学观察表明，患儿在生长发育过程中，周围神经普遍受累，以粗有髓神经纤维明显，主要为各种脱髓鞘病变，且呈髓鞘轴索分离现象。无髓神经纤维以其周围的雪旺氏细胞病变为主，束内微血管亦发生病变。神经受损后无修复与再生。此周围神经的病变程度与病程长短及临床症状无明显关系，可能与患者患病时所处的发育阶段、中枢神经元的受损状况及后天有关反射弧的代偿性建立等有关。

The morphology of lumbosacral spinal nerve dorsal roots coming from selective posterior rhizotomy in 20 patients with spastic cerebral palsy was observed with light and transmission electronic microscopy to get further understanding on the relationship between the pathological process of this disease and clinical symptoms.The results showed a different degree of demyelination changes,but the axons keeped relatively intact.Schwann's cell showed obvious abnormality,nuclear chromatin became pyknosis and cytoplasm became denseness.In severe damage,axons also had degeneration.The microvasculars within perineurium got pathological changes too.All the nerves affected had no repair and regeneration.The degree of pathological changes in peripheral nerves had no distinctly relationship with both the existing time of the brain damage and the clinical symptoms,but perhaps related to the developing stage of the patients when they got disease,to the degree of brain damage and the establishment of compensatory reflex arc in later time.