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目的 观察格林-巴利综合征中枢神经系统病理改变及MMP-9、TNF-α免疫表达。方法 5例剖检病人。常规取块,光镜观察。结果 (1)大脑锥体细胞多呈缺血性改变,海马锥体细胞轻微脱落,脑干运动神经核细胞染色质溶解。(2)桥脑小血管周围淋巴细胞浸润,1例额叶白质灶性脱髓鞘。(3)1例小脑分子层存在胶质结节。(4)MMP-9表达于血管内皮细胞大脑脑干神经元细胞。TNF-α表达于胶质细胞及神经元细胞。结论 (1)桥脑小血管周围淋巴细胞浸润是免疫应答在中枢内的典型表现。(2)胶质结节提示有嗜神经病毒感染的可能。(3)大脑灶性脱髓鞘表明GBS可以合并中枢病理改变。(4)MMP-9及TNF-α在GBS发病中扮演重要角色。
Objective To observe the pathological changes of central nervous system and the expression of MMP-9 and TNF-α in Guillain-Barre syndrome. Methods 5 cases of autopsy patients. Take the block routine, light microscopy. Results (1) Most of the pyramidal cells of the brain showed ischemic changes. The pyramidal cells of the hippocampus slightly shed and the motoneuron of the brainstem chromatin dissolved. (2) Peripheral lymphocyte infiltration of pontine brain and 1 case of demyelination of frontal white matter. (3) 1 case of cerebellar molecular layer exists glial nodules. (4) MMP-9 is expressed in brain stem cells of vascular endothelial cells. TNF-α is expressed in glial cells and neuronal cells. Conclusions (1) Peripheral lymphocyte infiltration of pontine is a typical manifestation of immune response in the central nervous system. (2) glial nodules suggest the possibility of neurotropic virus infection. (3) Focal demyelination of the brain indicates that GBS can be combined with central pathological changes. (4) MMP-9 and TNF-α play an important role in the pathogenesis of GBS.