糖尿病和非糖尿病脑梗死脑组织和血管病理改变的初步观察(附6例报告)

A Preliminary Study on Pathological Changes of Brain Tissue and Vessels in Patients with Diabetic and Non-diabetic Cerebral Infarction:6 Cases of Pathological Reports

目的 :探讨糖尿病脑梗死炎性机制的病理特征。方法 :用组织化学方法观察 6例脑梗死患者 (糖尿病及非糖尿病各 3例 )的脑组织及血管形态 ,免疫组化观察ICAM 1和VCAM 1的表达及分布。结果 :糖尿病脑梗死患者脑内腔隙灶显著多于非糖尿病患者。两者梗死区均存在明显的中性粒细胞浸润 ,微血管ICAM 1染色阳性率在梗死区和非梗死区分别为 (88± 7) %和 (15± 5 ) % ,但非梗死侧微血管ICAM 1表达在糖尿病患者中显著增高。结论 :糖尿病性脑梗死患者血管的病理改变以微血管病变为主。ICAM

Aim:To explore the pathological features of ischemia induced inflammation in cerebral infarction patients with diabetes mellitus. Methods:The morphological changes and expressions of ICAM 1 and VCAM 1 in brain tissue and vessels in 6 cases of diabetic and non diabetic cerebral infarction were observed by using the methods of histochemistry and immunohistochemistry, respectively. Results:The lacunar infarcts in the patients with diabetes mellitus were markedly more than those in the non diabetic patients, but a distinct accumulation of leukocytes was observed in the infarct area of all patients. ICAM 1 stained microvessels in the infarcted and noninfarcted hemispheres were 88±7% and 15±5% ( P <0 01), respectively; and the ICAM 1 expression on noninfarcted hemisphere of diabetics seemed to be increased, compared with that of non diabetics. Conclusion:The microvascular injury may be a major pathological manifestation diabetic cerebral infarction. The granulocyte infiltration at the early period of stroke caused by the striking upregulation of endothelial ICAM 1 expression may be one of the pathophysiological mechanisms of the poor prognosis in stroke with diabetes mellitus.