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目的 报道 1 2例多发性硬化 (MS)患者周围神经病理检查的异常改变 ,从中证实MS患者存在周围神经的节段性脱髓鞘病损。方法 1 2例经肌电图检查发现存在周围神经异常改变的患者行腓肠神经活检及病理学观察。结果 1 1例标本形态上以脱髓鞘为主 ,8例可见有髓纤维减少。电镜下显示髓鞘脱失 ,有髓纤维再生、形成空泡 ;神经膜细胞增生形成葱头样改变 ;7例可见髓鞘板层松解现象。结论 MS患者不但出现CNS的脱髓鞘病损 ,而且部分患者同时存在周围神经系统的脱髓鞘病损。
Objective To report the abnormal changes of peripheral neuropathological examination in 12 patients with multiple sclerosis (MS), and to confirm the existence of segmental demyelinating lesions of peripheral nerves in MS patients. Methods One hundred and twenty-two patients who had abnormal peripheral nerves by electromyography were examined with sural nerve biopsy and pathology. Results 1 1 specimens mainly demyelination, 8 cases of reduced myelinated fibers. Electron microscopy showed demyelination, myelinated fiber regeneration, the formation of vacuoles; nerve cell membrane formation of onion-like changes; 7 cases of myelin sheath delamination phenomenon. Conclusion MS patients not only have CNS demyelinating lesions, but also some patients have peripheral nerve system demyelinating lesions.