高血压病脑细动脉病理变化与脑出血的关系的探讨

The Relationship Between Arteriolar Pathological Changes and Brain Hemorrhage in Primary Hypertension Cases

为了探讨高血压病脑细动脉(<300μm)的病理改变与脑出血的关系 ，作者对 45例高血压病尸检的脑进行了大体及组织学观察。结果：45例中有40例脑细动脉有透明变性 ， 其中26例有出血。脑细动脉透明变性可分为末端细动脉腔变窄和近端细动脉腔扩张两型，出 血发生在后者。另有3例细动脉急性坏死及5例细动脉粥样硬化与出血有关。结论：高血压病 脑出血主要发生在扩张的透明变性的细动脉，少数出血可能与细动脉急性坏死或动脉粥样硬 化有关。

This study was intended to elucidate the relationship between arte riolar pathological changes and encephalorrhagia in the cases of primary hyperte nsion. Gross anatomy and histology of brain were observed in autopsy of 45 cases of primary hypertension. Forty cases of arteriolar hyalinization including 26 cases of brain hemorrhage were found in those 45 cases of primary hypertension. The hyalinized arterioles were divided to two types.One is characterized by the narrow lumen of terminal arterioles, the other by the dilatant lumen of proximal arterioles. Hemorrhage always occurred in the latter type. Besides these chang es, 3 cases of acute necrosis and 5 cases of atherosclerosis in arterioles were related to hemorrhage. These data suggest that brain hemorrhage of primary hyper tension mainly occur in dilated and hyalinized arterioles,and some cases are pro bably related to acute necrosis or atheroscleromatous atrerioles.