帕金森病合并脑小血管病人脑组织病理学分析：附一例报告并文献复习

doi:10.3969/j.issn.1672-6731.2021.04.006

中国现代神经疾病杂志 ›› 2021, Vol. 21 ›› Issue (4): 255-261. doi: 10.3969/j.issn.1672-6731.2021.04.006

• 神经病理与人脑组织库建设 • 上一篇下一篇

2 帕金森病合并脑小血管病人脑组织病理学分析：附一例报告并文献复习

曹凌晓¹, 董威¹, 李渊², 李少祥³, 陈彪², 黄越¹

1 100070 首都医科大学附属北京天坛医院神经病学中心国家神经系统疾病临床医学研究中心;
2 100053 北京, 首都医科大学宣武医院神经内科国家老年医学临床研究中心;
3 100070 首都医科大学附属北京天坛医院病理科

收稿日期:2021-04-07 出版日期:2021-04-25 发布日期:2021-04-27
通讯作者: 黄越,Email:yue.huang@ncrcnd.org.cn;陈彪,Email:pbchan@hotmail.com
基金资助:
国家自然科学基金资助项目（项目编号：82071417）

Brain pathological analysis of Parkinson's disease combined with cerebral small vessel disease: one case report and literature review

CAO Ling-xiao¹, DONG Wei¹, LI Yuan², LI Shao-xiang³, CHAN Piu², HUANG Yue¹

1 Center of Neurology, Beijing Tiantan Hospital, Capital Medical University;China National Clinical Research Center for Neurological Diseases, Beijing 100070, China;
2 Department of Neurology, Beijing Xuanwu Hospital, Capital Medical University;National Center for Geriatrics Clinical Medicine Research, Beijing 100053, China;
3 Department of Pathology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China

Received:2021-04-07 Online:2021-04-25 Published:2021-04-27
Supported by:
This study was supported by the National Natural Science Foundation of China (No. 82071417).

摘要/Abstract

摘要：

目的报道1例帕金森病合并脑小血管病人脑组织的病理学特点。方法与结果 男性患者，69岁，猝死后9.50小时由首都医科大学附属北京天坛医院国家神经系统疾病临床医学研究中心人脑组织库完成脑组织捐献及接受工作。生前诊断为帕金森病，曾行脑深部电刺激术，但无脑小血管病的临床诊断。按照国际标准化脑库的脑组织处理流程，大体标本观察可见脑干黑质和蓝斑显著色素脱失，以及脑深部电刺激路径；组织病理学除帕金森病晚期（Braak分期Ⅴ期）病理表现外，还可见脑深部电刺激术后病理改变，以及额叶、颞叶、扣带回、基底节区和脑干等区域存在微小血管平滑肌细胞增生、管壁增厚变硬、玻璃样变、管腔狭窄，小血管周围间隙扩大，白质微梗死和小血管微出血的脑小血管病病理改变。最终病理诊断为帕金森病（Braak分期Ⅴ期），脑深部电刺激术后，脑小血管病。结论该例捐献者脑组织以帕金森病的临床诊断入库，病理证实除帕金森病和脑深部电刺激术后病理改变外，同时并存脑小血管病病理改变，提示应重视老年人群的多病共病。

关键词: 帕金森病, 深部脑刺激法, 大脑小血管疾病, 病理学, 人脑组织库(非MeSH词)

Abstract:

Objective To report on the pathological characteristics of brain tissue in a case of Parkinson's disease (PD) with cerebral small vessel disease (CSVD). Methods and Results The male patient, 69 years old, was suddenly died. His brain tissue was donated and accepted by the Human Brain Tissue Bank of China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, 9.50 h after sudden death. The patient was diagnosed with PD, and had undergone deep brain stimulation (DBS), but there was no clinical diagnosis of CSVD. We processed the brain tissue according to standardized procedure of international brain banks. Gross observation showed there was significant discoloration in the substantia nigra and locus coeruleus. The DBS pathway was also visible. Microscopic observation showed in addition to advanced stage of PD (Braak stage Ⅴ), pathological changes of DBS could also be seen, as well as CSVD pathological changes such as microvascular smooth muscle cell proliferation, thickening and hardening vessel walls, hyaline degeneration, lumen stenosis, severe perivascular dilatation, white matter microinfarction and microhemorrhage in frontal lobe, temporal lobe, cingulate gyrus, basal ganglia, brainstem and other areas. The final pathological diagnosis was PD (Braak stage Ⅴ) after DBS and CSVD. Conclusions This brain tissue was enrolled into the brain bank for the clinical diagnosis of PD. Pathological examination showed that in addition to the pathological changes of PD and DBS, CSVD was also coexisted. This case suggests that attention should be paid to the multiple comorbidities of neurological diseases of the elderly.

Key words: Parkinson disease, Deep brain stimulation, Cerebral small vessel diseases, Pathology, Human brain bank (not in MeSH)

曹凌晓, 董威, 李渊, 李少祥, 陈彪, 黄越. 帕金森病合并脑小血管病人脑组织病理学分析：附一例报告并文献复习[J]. 中国现代神经疾病杂志, 2021, 21(4): 255-261.

CAO Ling-xiao, DONG Wei, LI Yuan, LI Shao-xiang, CHAN Piu, HUANG Yue. Brain pathological analysis of Parkinson's disease combined with cerebral small vessel disease: one case report and literature review[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2021, 21(4): 255-261.

https://journal11.magtechjournal.com/cjcnn/CN/Y2021/V21/I4/255

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2 帕金森病合并脑小血管病人脑组织病理学分析：附一例报告并文献复习

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