创伤性脑弥漫性轴突损伤的超微结构研究

Ultrastructure Research of Traumatic Diffuse Axonal Injury

目的 :为了探讨创伤性脑弥漫性轴突损伤的病理生理机制 .方法 :对 2 4例诊断为创伤性脑弥漫性轴突损伤患者作内减压手术时 ,取病灶脑白质标本进行了透射电子显微镜检查 .结果 :超微结构的研究显示 :早期轴膜分层、断裂 ,横向呈花环样改变 ,纵向呈串珠样改变 ,中期轴突挫伤处微丝微管断裂 ,断裂处近端细胞器积聚 ,远端细胞器紊乱 ,再向后积聚的细胞器肿胀 ,而断裂处的远端轴突内的细胞器空无 ,即光镜下的回缩球形成 ;晚期轴突断裂 ,细胞器溢出 ,回缩球现象消失 .结论 :(1)回缩球现象是由于细胞器在轴突损伤部位积聚而致 ;(2 )轴突损伤与轴突的走向明显相关 ;(3)同一区域内粗大的轴突的轴膜较纤细的轴突更易受到损害 ;(4 )

Objective: To investigate the ultrastructure of traumatic diffuse axonal injury(DAI). Method: The white material sample from traumatic brains performed decompress operation were examined by electron microscopy. Results: Ultrastructure research revealed that the membrane of axon was layered and broken in early stage, it presented flower-like circle in cross section and pear line in straight section. Micro-silk and micro-tube were broken in those damaged axon. Conclusion: Retraction ball(RB) is due to Golgi body accumulated at injury area. Axonal injury happens related to whether or not the force vertical to axon. Large axon is more easily damaged than thin axon at the same injury area. Only brain edema or enlargement is not the single necessary to DAI diagnosis.