摘要
观察新生儿缺氧缺血性基底节损伤 (BGI)的病理特点、探讨多巴胺转运蛋白 (DAT)和多巴胺D2受体 (D2R)变化与急性缺氧缺血性BGI的关系。光镜检查 63例HIE死亡患儿脑HE染色标本 ,并用免疫组化链酶菌抗生物素蛋白 -过氧化物酶连结法 (简称S -P法 )检查 1 8例急性缺氧缺血性BGI的DAT和D2R的变化。结果显示 :42 9%(2 7/63 )的HIE患儿有BGI,其中急性BGI 1 8例 ,慢性BGI 9例。在早产儿 ,急性BGI主要表现为神经元核裂解 ,而在足月儿主要表现为神经元嗜酸性变 ,组织坏死在早产儿比足月儿更明显。 1 8例急性BGI中 ,7例相对轻的BGI病例 ,其基底节的神经元和神经纤维对DAT免疫反应增强 ,而 8例较重的BGI病例 ,其基底节的神经元和神经纤维对DAT免疫反应减弱。在所有急性BGI病例 ,基底节D2R阳性神经元均减少 ,其减少的区域恰好与基底节损伤区域一致 ,减少的程度也与基底节损伤程度相平行。结论认为 ,早产儿和足月儿缺氧缺血性BGI的病理改变可能由于神经元的成熟性或和易损性不同略有差别 ,DAT和D2R参与了缺氧缺血性BGI,基底节对缺氧缺血易损可能与其神经化学解剖结构有关。
To investigate the neuropathological characteristics of the neonatal hypoxic-ischemic basal ganglia injury (BGI), and relationship between changes of the dopamine transporter (DAT), dopamine D2 receptor (D2R) and hypoxic-ischemic BGI. Cerebral HE-stained sections of 63 cases of HIE clinically diagnosed were evaluated by light microscopy, and 18 cases of acute BGI were selected for DAT and D2R immunohistochemical study. Results showed that BGI was observed in 42.9% (27/63) of HIE cases, 18 cases being acute, 9 cases being chronic. Acute BGI mainly manifested neuronal karyorrhexis in premature infants and eosinophilia in full-term infants. Tissue necrosis was more predominant in premature than in full-term infants. In 18 cases of acute BGI, increased DAT immunoreactivity of neuron and neuropile in the basal ganglia was observed in 7 infants, who manifested relatively mild BGI. DAT immunoreactivity of neuron and neuropile in the basal ganglia was found to be decreased in 8 infants, who manifested relatively marked BGI. Number of D2R-positive neurons was decreased in all cases of acute BGI, the areas of decreased D2R-positive neurons corresponded to the damaged regions observed on HE staining, and the decreased number of positive neurons was consistent with the degree of BGI. It could the concluded that there is a little difference of neuropathological characteristics of acute hypoxic-ischemic BGI between premature and full-term infants, probably due to different mature or/and vulnerability of neurons. DAT and D2R are involved in hypoxic-ischemic BGI and the vulnerability of the basal ganglia to hypoxia or ischemia may be related to its neurochemical anatomical structure.
出处
《新生儿科杂志》
2001年第6期256-258,255,共4页
The Journal of Neonatology
基金
国家教委留学回国人员基金资助项目
