摘要
背景:额叶型痴呆患者脑组织的病理改变尚有争议,文章通过1例已死亡痴呆患者脑组织的病理研究,提出额叶型痴呆脑组织病理改变特征。目的:拟证实一种非常见的伴有痴呆的神经系统变性疾病———额叶型痴呆。设计:病例分析。单位:吉林大学第一医院神经内科。方法:对1例进行性痴呆患者死后3h进行脑部解剖检查,系列的组织染色及PrP,tau蛋白等免疫组织化学染色。主要观察指标:①临床症状。②头部CT和脑电图检查结果。③脑部解剖检查结果。④免疫组织化学染色结果。结果:①进行性神经、精神症状,病程为3年。②头部CT示双侧额叶灰质萎缩,脑电图呈阵发性全导联,长间歇期(>2s)的高波幅慢波。③脑质量1050g,脑萎缩仅限于额叶,未累及颞叶。④额叶灰质从第2层开始神经细胞大量脱失伴明显胶质增生,而锥体细胞相对完好。Beilschowsky及Gallyas染法无异常发现。⑤神经细胞及胶质细胞内未发现任何包涵体。⑥PrP,tau蛋白免疫组织化学染色呈阴性反应。结论:该病例为典型额叶型痴呆,今后在分析伴有痴呆的神经系统变性疾病时,应想到此类型痴呆。
BACKGROUND:Pathological changes of the brain tissue in patients with dementia of frontal type(DFT) are still controversial.This paper brought forward the pathological alterative characteristics of brain tissue in DFT patients through one pathological case study of the brain tissue in one dead dementia patient. OBJECTIVE:To validate one uncommon neurodegenerative disease complicated with dementia,DFT. DESIGN:A case analysis. SETTING:Department of Neurology of the First Hospital of Jilin University METHODS:Brain anatomy,serials of histological staining and immunohistochemical staining for PrP,tau protein,etc.were performed after 3 hours since the death of one patient with progressive dementia. MAIN OUTCOME MEASURES:①Clinical symptoms;②Brain CT and electroencephalogram(EEG);③Brain anatomy;④Immunohistochemical staining RESULTS:①Progressive neurological and mental symptoms with a course of the disease of 3 years;②Brain CT suggested atrophy in both frontal lobes.EEG displayed a paroxysmal high amplitude slow wave with long intermission(> 2 s)in entire leads;③Brain quality was 1 050 g and the brain atrophy was limited to frontal lobe and the temporal lobe was not involved;④The grey matter in frontal lobe began to have lots of loss of neurocyte companied with significant gliosis since the second layer;However,the pyramidal cell was relatively healthy.No abnormality was found in Beilschowsky and Gallyas staining;⑤No any kind of inclusion body was found in neurocyte and gliocyte;⑥PrP and tau proteinic immunohistochemical staining had negative reactions. CONCLUSION:This case was typical DFT.This type of dementia should be considered in future analysis of the neurodegenerative disease complicated with dementia.
出处
《中国临床康复》
CSCD
北大核心
2005年第13期215-217,i006,共4页
Chinese Journal of Clinical Rehabilitation
