DIFFUSE MICROGLIOSIS ASSOCIATED WITH CEREBRAL ATROPHY IN THE ACQUIRED-IMMUNODEFICIENCY-SYNDROME
DIFFUSE MICROGLIOSIS ASSOCIATED WITH CEREBRAL ATROPHY IN THE ACQUIRED-IMMUNODEFICIENCY-SYNDROME
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DOI：
10.1002/ana.410340112
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发表时间：
1993-07-01
影响因子：
11.2
通讯作者：
GELMAN, BB
中科院分区：
文献类型：
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作者：
GELMAN, BB
获得性免疫缺陷综合征（AIDS）患者脑萎缩的原因尚不清楚，因为人类免疫缺陷病毒1型（HIV-1）相关的组织病理学改变几乎与脑萎缩无关。在这项研究中，将脑室扩张与尸检时的单核细胞和星形胶质细胞额叶密度进行了比较。28名男性艾滋病患者表现出不同程度的萎缩，与17名年龄匹配的没有艾滋病或萎缩的男性对照组进行比较。在均匀切片、福尔马林固定的脑标本中测量心室扩张指数，并在左侧额上回（Brodmann区8）冠状切片上用免疫化学标记的细胞（野计数和平面测量法）进行定量。在皮层中，弥漫性铁蛋白染色的小胶质细胞和胶质纤维酸性蛋白阳性星形胶质细胞的数量约为艾滋病患者的两倍。65%（18/28）艾滋病患者的小胶质细胞密度高于对照平均值2个标准差以上。小胶质细胞密度与心室扩张的严重程度呈正相关（r = 0.71, p < 0.0001），而肥大的星形胶质细胞密度与心室扩张的严重程度相关性极弱。在白质中，ham -56阳性巨噬细胞和胶质纤维酸性蛋白阳性星形胶质细胞与心室扩张指数无显著相关。脑室扩张和弥漫性皮质小胶质瘤是艾滋病患者中非常普遍的异常，它们之间的相互关系可能比以前认识到的更为重要。
The cause of cerebral atrophy in patients with acquired immunodeficiency syndrome (AIDS) is obscure because human immunodeficiency virus type 1 (HIV-1)-related histopathological changes hardly correlate with cerebral atrophy. In this study, brain ventricular expansion was compared to the frontal lobe density of mononuclear and astroglial cells at autopsy. Twenty-eight male patients with AIDS displaying varying degrees of atrophy were compared to 17 age-matched male control subjects without AIDS or atrophy. An index of ventricular expansion was measured in uniformly sliced, formalin-fixed brain specimens, and immunochemically marked cells in coronal sections of the left superior frontal gyrus (Brodmann area 8) were quantified by field counting and planimetry. In the cortex, diffuse ferritin-stained microglia and glial fibrillary acidic protein-positive astrocytes were about twice as numerous in the patients with AIDS. Sixty-five percent (18/28) of the patients with AIDS had a microglial cell density greater than 2 standard deviations above the control mean. Microglial cell density was correlated positively with the severity of ventricular expansion (r = 0.71, p < 0.0001), while hypertrophied astroglial cells were very weakly related. In white matter, Ham-56-positive macrophages and glial fibrillary acidic protein-positive astrocytes were not meaningfully correlated with the index of ventricular expansion. Brain ventricular expansion and diffuse cortical microgliosis are highly prevalent anomalies in patients with AIDS, and their interrelationship may be more important than previously recognized.