人脑小动脉玻璃样变细胞外间质免疫组化研究(英文)

Immunohistochemical study of hyalinosis of microvessels in the human brain

目的采用免疫组化对8例老年脑小动脉玻璃样变病例的小动脉管壁结构进行了研究,探索老年微小血管玻璃样变性的发病机制。方法尸解材料来自8例经HE染色鉴别具有脑内小动脉玻璃样变的病例(Binswanger病3例,多发性脑梗死5例)。男6例,女2例,年龄66～99岁。对照组:8例,均无脑病理学改变,男5例,女3例,4例死于心脏病,4例死于恶性肿瘤,年龄28～80岁。采用免疫组化ABC法及胶原I、II、IV、VI型,肌动蛋白,心中无层蛋白,VIII因子,CD-34,葡萄糖载体I抗体对8例病理证实脑小动脉玻璃样变的病例和8例无脑病的对照组进行研究。结果脑小动脉玻璃样变性的病理特点为:I,III,V,VI型纤维胶原异常堆积在中层和外层,基底层成分胶原IV和层蛋白主要堆积在血管基底膜和中层平滑肌层。结论玻璃样变的小动脉由于中层平滑肌细胞变性和胶原沉积使血管对神经和代谢调节的反应降低,进而影响脑血流的调节。

Aim Immumohistochemical method was use d to study 8pa-tients with hyalinosis of microvessels,to explore pathogenic mechanis m of hyalinosis of microvessels in the human brain.Methods Autopsy material was obtained from 8patients with morphological signs of hyalinosis of in trac-erebral microvessels identified wi th haematoxylin eosin stain.Eight c ases(5males,3females,28-80years of age)without signs of brain pathology were used as controls;four of them died of heart diseases and four from malignant tumours.These cases have been used a s controls in two parallel studies:Bin-swanger' encephalopathy and congophilic angiopathy.Immumohistochemical ABC method with collagens type I,II,IV,VI,actin,ulex,factor VIII,CD-34,glucose transporter 1antidoby were used to study 8cases with hyalinosis of microvessels and 8cases without encephalopathy.Results collagens type I,II,IV,VI were stacked at middle layer and external layer of microvessels vas-cular wall abnormally.Basal layer c omponents,collagen type IV and lami nin mostly stacked at basement membrane of blood vessel and smooth muscle lay er of middle layer.Conclusio n Degeneration of smooth muscle cell s of the media and deposition of collagens and other substances probably reduce the cap acity of hyaline arterioles to respond to neurogenic and metabolic influences,thereby jeopardizing their ability to modul ate cerebral blood flow.