慢性特发性轴索性多神经病的病理及免疫组化研究

发布时间：2018-03-01 00:04

  本文关键词： 慢性特发性轴索性多神经病 腓肠神经 血栓调节蛋白 内皮源性一氧化氮合酶　出处：《中风与神经疾病杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的 研究慢性特发性轴索性多神经病(chronic idiopathic axonal polyneuropathy,CIAP)病理改变特点,并探索腓肠神经炎细胞CD3、CD20、CD68抗体及其微小血管内皮细胞膜结合性血栓调节蛋白(thrombomodulin,TM)、内皮源性一氧化氮合酶(endothelial-nitricoxide synthase,e NOS)的表达规律。方法 10例经过临床、电生理、腓肠神经活检病理检查证实的CIAP患者,均进行腓肠神经活检标本的常规病理组织学染色以及以抗CD3、CD20、CD68、TM、e NOS、v WF(von Willebrand factor,v WF)抗体作为第一抗体的免疫组织化学染色。结果 10例患者腓肠神经病理检查显示有髓神经纤维轻-中度减少,伴随轴索变性和再生,部分可见轻微脱髓鞘改变,4例患者出现毛细血管基底膜肥厚。4例患者腓肠神经神经束衣间小血管周围有散在分布的CD68阳性单核细胞浸润。所有患者血管内皮细胞v WF、e NOS、TM均正常表达。结论 CIAP病理特点为轴索损害为主,发病可能和体液免疫异常有关,部分患者毛细血管基底膜肥厚提示血管内皮细胞可能受损,但内皮细胞功能相关蛋白表达初步提示正常。
[Abstract]:Objective to study the pathological changes of chronic idiopathic axonal polyneuropathy in chronic idiopathic axonal polyneuropathy (CIP). To investigate the expression of CD3 + CD20 + CD68 antibody and thrombomodular thrombomodulin (TMN) and endothelial-derived nitric oxide synthase (NOS) in sural neuritis cells, 10 patients with sural neuritis were enrolled in this study. Sural nerve biopsy confirmed by pathological examination in patients with CIAP, All the specimens of sural nerve biopsy were stained by routine histopathology and immunohistochemical staining of anti CD3 + CD20 WF(von Willebrand factor v WF.Results the pathological examination of sural nerve showed myelinated nerve in 10 patients. Mild to moderate fiber reduction, With axonal degeneration and regeneration, Some slight demyelinating changes were observed in 4 patients with capillary basement membrane hypertrophy. 4 patients had scattered CD68 positive monocyte infiltration around the small vessels between the sural nerve bundles. Vascular endothelial cells were found in all patients. Conclusion the pathological features of CIAP are axonal damage. The pathogenesis may be related to the abnormal humoral immunity. The hypertrophy of capillary basement membrane suggests that vascular endothelial cells may be damaged, but the expression of function-related proteins of endothelial cells may be normal.
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