CAJ | 학술논문

目的研究新疆少数民族地区自发性脑出血患者中淀粉样脑血管病相关性脑出血(CAAH)的比例及其病理特点.方法经头颅CT证实为自发性脑出血的124例患者来自于有代表性的南北疆6家三级甲等医院,入组患者接受开颅手术,标本取白血肿腔周围,通过HE染色、刚果红染色偏振光显微镜观察、β淀粉样蛋白(Aβ)免疫组化检测明确是否存在脑血管淀粉样变性.结果124例患者中11例为CAAH,占8.9％,其中4例为嗜刚果红血管病,1例表现为斑样血管病,6例为混合型.结论新疆少数民族地区手术治疗的自发性脑出血患者中8.9％与淀粉样脑血管病(CAA)相关,其比例随年龄增加；CAA表现为受累的血管壁增厚,血管壁正常结构消失,淀粉样物质在血管被膜中层和外膜中沉积；部分患者脑实质内可见β淀粉样蛋白沉积.
목적 연구신강소수민족지구자발성뇌출혈환자중정분양뇌혈관병상관성뇌출혈(CAAH)적비례급기병리특점.방법 경두로CT증실위자발성뇌출혈적124례환자래자우유대표성적남북강6가삼급갑등의원,입조환자접수개로수술,표본취백혈종강주위,통과HE염색、강과홍염색편진광현미경관찰、β정분양단백(Aβ)면역조화검측명학시부존재뇌혈관정분양변성.결과124례환자중11례위CAAH,점8.9％,기중4례위기강과홍혈관병,1례표현위반양혈관병,6례위혼합형.결론 신강소수민족지구수술치료적자발성뇌출혈환자중8.9％여정분양뇌혈관병(CAA)상관,기비례수년령증가；CAA표현위수루적혈관벽증후,혈관벽정상결구소실,정분양물질재혈관피막중층화외막중침적；부분환자뇌실질내가견β정분양단백침적.
Objective To study the prevalence and neuropathological characteristics of cerebral amyioid angiopathy hemorrhage( CAAH )in spontaneous intracerebral hemorrhage( SICH ) patients of Xinjiang minority areas.Methods From May 2009 to March 2011,124 patients admitted to six hospitals throughtout Xinjiang for acute SICH.The patients were suffered from SICH proved by computed tomography scan(CT).Emergent craniotomy for hemorrhage evacuation were performed for those patients within 72 h after hemorrhage onset and brain tissue around the hematoma was also obtained for histological examination through HE dyed 、Congo Red stained under polarized light microscope and Aβ immunochemistry to verify the existence of CAA.Results 11 patients were identified as CAAH and the total ratio was 8.9％.Among which 4 cases were congophilic angiopathy,1 plaque - like angiopathy,6 mixed type.Conclusions 8.9％SICH are associated with CAA in Xinjiang minority areas.The vessel walls of CAA become thickening and the normal vessel structures disappear.β -amyloid protein is mainly deposited in small arteries,middle and outer membrane.In some patients,β -amyloid protein is deposited in brain.