三叉神经根区周围蛛网膜粘连与HSV-1感染关系的实验研究

目的 研究三叉神经痛患者三叉神经根区周围蛛网膜粘连与单纯疱疹病毒Ⅰ型感染的关系.方法 实验组40 例三叉神经痛患者三叉神经根区粘连的蛛网膜,对照组20 例外伤患者蛛网膜,每例蛛网膜分别做病理切片,PCR 检测HSV-1 特异性基因片段以及用HSV-1 单克隆抗体检测抗原的表达.结果 实验组病理切片光镜下粘连的蛛网膜主要以炎细胞浸润、水肿、钙化以及粘液样变性为主,检测到HSV-1 特异性基因片段阳性率为72.5% (29 /40),抗原阳性率为17.5% (7 /40),即以潜伏感染为主,少部分呈增值性感染.对照组病理切片有3 例细胞轻度水肿,余均为正常蛛网膜结构.有4 例HSV-1 特异性基因片段阳性,无抗原阳表达.卡方检验实验组和对照组蛛网膜HSV-1 的感染率有统计学差异(P＜0.05).结论 三叉神经根区蛛网膜的粘连与HSV-1 的感染密切相关;粘连的蛛网膜加剧了根区动脉对三叉神经根的压迫,是加重三叉神经痛的病因之一.

Study on relationship between arachnoid adhesions around trigeminal nerve root zone and HSV-1 infection

Objective To study the relationship between arachnoid adhesions around trigeminal nerve root zone and Herpes simplex virus-1 （HSV-1） infection. Methods A total of 40 cases of adhesion of arachnoid were taken from the trigeminal nerve root zone when operated to those patients with trigeminal neuralgia as experimental group. Another 20 cases of arachnoid were taken from craniocerebral injury patients as control. Each case was to do pathological section, at the same time to detect the DNA and antigen of HSV-1. Results The pathological changes in experimental group mainly appeared as inflammatory cell infiltration, edema and ＇degeneration. The positive rate of HSV-1 gene was 72.5% ,and the HSV-1 antigen positive rate was 17.5%. There were 3 cases with mild edema in control group, the rest were normal. 4 caese of HSV-1 gene were deteced, and no HSV-1 antigen was found in control group. There was a significent difference of HSV-I infection rate between experimental group and control group （P 〈 0. 05 ）. Conclusions There is a close relationship between arachnoid adhesions around trigeminal nerve root zone and HSV-I infection. Arachnoid adhesions wrapping arterial and trigeminal nerve which increased pressure on the trigeminal nerve, aggravate trigeminal neuralgia.