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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。
Objective To study the wall structure of arterioles in 8 cases of elderly patients with arteriolar hyaline degeneration by immunohistochemistry to explore the pathogenesis of vitreous degeneration in elderly patients. Methods The autopsy material was obtained from 8 patients with intracerebral arteriolar hyaline degeneration (3 from Binswanger’s disease and 5 from multiple cerebral infarction) by HE staining. 6 males and 2 females, aged 66 to 99 years. Control group: 8 cases, no changes in brain pathology, 5 males and 3 females, 4 died of heart disease, 4 patients died of malignant tumors, aged 28 to 80 years. Immunohistochemical ABC method and collagen type I, II, IV, VI, actin, heart no layer protein, factor VIII, CD-34, glucose carrier I antibody in 8 cases of pathologically confirmed cases of small arteriole glassy And 8 cases of encephalopathy control group to study. Results The histopathological features of arteriolar hyaline degeneration were as follows: Type I, III, V, and Type VI fibrillar collagen accumulated abnormally in the middle and outer layers. Collagen IV and laminin in the basilar layer mainly accumulated in the vascular basement membrane and the middle smooth muscle layer. CONCLUSIONS: The hyalinized arterioles reduce the response of blood vessels to nerve and metabolic regulation due to the degeneration and collagen deposition of smooth muscle cells in the middle layer, thereby affecting the regulation of cerebral blood flow.