格林-巴利综合征病理变化观察

本文对9例完整的GBS屍检进行了观察并对其病理改变、发病机理、病理—临床联系进行了讨沦。本组病例揭示:多数病例的周围神经损伤严重的时间在一周左右;运动神经病变比感觉神经重;神经根病变比远端明显;脊神经病变比颅神经重。9例中,有一例伴有大脑的急性脱髓鞘改变。

OBSERVATIONS AT AUTOPSY IN NINE CASES OF GUILLAIN-BARRE SYNDROME

Pathological features noted at autopsy in nine cases of GBS are described, and correlated with the clinical picture.Characteristically, a perivenular inflammatory response, composed primarily of lymphocytes and macrophages, occurs in a segment, or group of segments, and extends from the most proximal nerve root to the distal nerve twigs. However, in some cases a propensity for motor root involvement was found. Segmental demyelin-ation was observed, very often in association with areas of inflammation. From this study we came to the conclusion that distal motor paralysis, as observed clinically,is probably related to particular damage to the proximal nerve roots as opposed to the distal parts of the nerves.- Four points in particular were noted with respect to the pathology of GBS. Firstly, the damage of the peripheral nerves in, most cases became obvious about one week after the beginning of the attack. Secondly, damage of the motor roots was found to be more marked than that of the sensory roots. Thirdly, lesions in the proximal nerve roots were more prominent than in the distal nerve twigs. Finally, we found that cranial nerves sustained less damage than spinal nerves.One case out of the nine showed acute perivennlar cerebral detnyelination.