《中国康复理论与实践》

《中国康复理论与实践》 ›› 2005, Vol. 11 ›› Issue (05): 382-383.

• 临床研究 • 上一篇    下一篇

肌萎缩侧索硬化症的周围神经损害

李越星1; 田淑芬2; 贾新州3; 吴丽娟1; 张秋荣1; 左越焕1   

  1. 1.北京大学第一医院神经内科 北京市 100034;2.贵阳医学院附属医院神经科 贵州贵阳市 550004;3.郑州市中心医院内一科 河南郑州市 450007
  • 收稿日期:2005-01-13 出版日期:2005-05-25 发布日期:2005-05-25

Lesion of the peripheral nerve in amyotrophic lateral sclerosis

LI Yue-xing,TIAN Shu-fen,JIA Xin-zhou, et al   

  1. Department of Neurology,Peking University First Hospital,Beijing 100034, China
  • Received:2005-01-13 Published:2005-05-25 Online:2005-05-25

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摘要： 目的阐明肌萎缩侧索硬化症患者腓肠神经的病理改变特点。方法选择已确诊的肌萎缩侧索硬化症患者行周围神经活检。取其腓肠神经进行光镜及电镜检查,观察其病理改变。结果周围神经的改变以轴索损害为主,伴有髓鞘的脱失。根据病理改变可分为4组:正常;轻度轴索变性及髓鞘脱失;有髓神经纤维轻度脱失,轴索变性及脱髓鞘;有髓神经纤维严重脱失,轴索变性及脱髓鞘。结论肌萎缩侧索硬化症患者常常早期即出现周围神经的损害,其中以轴索性的改变为主,同时可伴有不同程度的髓鞘脱失。

关键词: 肌萎缩侧索硬化症, 周围神经, 病理, 活检

Abstract: ObjectiveTo investigate the pathologic characteristics of the sural nerve in amyotrophic lateral sclerosis. MethodsClinical, electrophysiologic, laboratory data and sural nerve biopsy of 11 patients were reviewed. The clinical and laboratory data were compatible with the diagnosis of ALS. The sural nerve was removed and immediately fixed in 10% formalin and phosphate-buffered 2.5% glutaraldehyde and processed according to the procedure used in our laboratory for light and ultrastructural examination.Results4 groups were distinguished based on pathologic changes: normal; with mild axon degeneration and demyelination; with mild loss of the myelinated nerve, axon degeneration and demyelination; with severe loss of the myelinated nerve, axon degeneration and demyelination.ConclusionPredominantly axonal neuropathies are common and occur early in ALS. Axon degeneration of the nerve fibers is predominant, and demyelination also can be performed in patients with ALS.

Key words: amyotrophic lateral sclerosis, peripheral nerve, pathology, biopsy