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目的 :探讨糖尿病脑梗死炎性机制的病理特征。方法 :用组织化学方法观察 6例脑梗死患者 (糖尿病及非糖尿病各 3例 )的脑组织及血管形态 ,免疫组化观察ICAM 1和VCAM 1的表达及分布。结果 :糖尿病脑梗死患者脑内腔隙灶显著多于非糖尿病患者。两者梗死区均存在明显的中性粒细胞浸润 ,微血管ICAM 1染色阳性率在梗死区和非梗死区分别为 (88± 7) %和 (15± 5 ) % ,但非梗死侧微血管ICAM 1表达在糖尿病患者中显著增高。结论 :糖尿病性脑梗死患者血管的病理改变以微血管病变为主。ICAM 1上调导致的早期炎性细胞浸润可能是糖尿病脑梗死预后差的病理生理基础
Objective: To investigate the pathological features of inflammatory mechanism in diabetic cerebral infarction. Methods: Six cases of cerebral infarction (diabetic and non-diabetic) were observed by histochemistry. The expression of ICAM-1 and VCAM-1 were observed by immunohistochemistry. Results: There were more brain cavity lesions in patients with diabetes mellitus than in non-diabetic patients. The infiltration of neutrophils was found in both infarction areas. The positive rate of ICAM-1 staining in microvessels was (88 ± 7)% and (15 ± 5)% in infarct area and non-infarct area respectively, but non-infarct side microvascular ICAM 1 Expression is significantly increased in diabetic patients. Conclusion: The pathological changes of blood vessels in patients with diabetic cerebral infarction are mainly microangiopathy. Early inflammatory cell infiltration caused by upregulation of ICAM 1 may be the pathophysiological basis of poor prognosis in diabetic cerebral infarction