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目的探讨Ｂｉｎｓｗａｎｇｅｒ病的病理基础及发病原因。方法对９例老年人Ｂｉｎｓｗａｎｇｅｒ病及１３例非痴呆老年对照组的尸检材料进行临床、病理组织形态学，免疫组化及测微观察。结果Ｂｉｎｓｗａｎｇｅｒ病组的病灶主要位于皮质下白质、侧脑室周围、内囊、基底节、甚或累及脑干及小脑；其病理基础为脱髓鞘、微小腔隙性梗死灶、胶质细胞增生及血管周围间隙扩大，脑白质深穿支小动脉壁明显增厚（１９．５０μｍ±４．３１μｍ），与对照组（６．２５μｍ±５．１３μｍ）比较差异有显著性，均为Ｐ＜０．０１。结论Ｂｉｎｓｗａｎｇｅｒ病并不少见；慢性高血压动脉硬化，脑缺血是Ｂｉｎｓｗａｎｇｅｒ病发病的重要因素。
Objective To investigate the pathological basis and pathogenesis of Binswanger’s disease. Methods The autopsy specimens of 9 cases of Binswanger’s disease and 13 cases of non-demented elderly control group were collected for clinical, histopathological, immunohistochemical and microscopic observation. Results The lesions in the Binswanger’s disease group were mainly located in the subcortical white matter, the lateral ventricle, the internal capsule and the basal ganglia, and even involved the brainstem and cerebellum. The pathological basis was demyelination, small lacunar infarction, glial cell proliferation and blood vessels (P <0.01), and there was a significant difference between the control group (6.25μm ± 5.13μm) and the control group (P <0.01) . Conclusion Binswanger’s disease is not uncommon. Chronic hypertension with arteriosclerosis and cerebral ischemia is an important factor in the pathogenesis of Binswanger’s disease.