Mawrin C, Schütz G, Schröder J M
Institut für Neuropathologie, Universitätsklinikum der Rheinisch-Westfälischen Technischen Hochschule Aachen, Germany.
Acta Neuropathol. 2001 Oct;102(4):364-72. doi: 10.1007/s004010100391.
In a preceding study it was shown that changes in the number of epineurial blood vessels may be a prominent feature in angiopathic and other peripheral neuropathies, for instance in vasculitis, diabetes mellitus, or cerebral autosomal dominant angiopathy with multiple infarcts and leukoencephalopathy (CADASIL). Endoneurial blood vessels usually may also show significant structural alterations in a broad spectrum of neuropathic conditions, although these are not as prominent as in the epineurium. However, the relationship between changes in the number of epineurial and endoneurial blood vessels in diseased human sural nerves, and the impact of the loss of myelinated nerve fibers on the number of endoneurial blood vessels has thus far not been determined. Therefore, we investigated and compared the number of epineurial and endoneurial blood vessels in 50 human sural nerve biopsy specimens, representing a variety of peripheral neuropathies. We found that despite a significant increase of the number of epineurial blood vessels in cases with vasculitic neuropathy (P<0.05) and neuropathy with other types of microangiopathy (P<0.01), the number and density of the endoneurial blood vessels remained remarkably constant. In cases with an axonal type of neuropathy, severe neuropathic changes were associated with a decreased epineurial blood vessel number and a simultaneous, relative increase in the endoneurial blood vessel density. No significant correlation was found between (1) the number of epineurial and endoneurial blood vessels, and (2) the severity of the neuropathy and the number or density of epineurial and endoneurial blood vessels.
在之前的一项研究中发现，神经外膜血管数量的变化可能是血管病变性及其他周围神经病变的一个显著特征，例如在血管炎、糖尿病或伴有多发梗死和白质脑病的常染色体显性遗传性脑动脉病（CADASIL）中。在广泛的神经病变情况下，神经内膜血管通常也可能表现出显著的结构改变，尽管这些改变不如神经外膜明显。然而，在患病的人类腓肠神经中，神经外膜和神经内膜血管数量变化之间的关系，以及有髓神经纤维的丧失对神经内膜血管数量的影响，迄今尚未确定。因此，我们调查并比较了50例人类腓肠神经活检标本中的神经外膜和神经内膜血管数量，这些标本代表了各种周围神经病变。我们发现，尽管在血管炎性神经病变（P<0.05）和其他类型微血管病变性神经病变（P<0.01）中神经外膜血管数量显著增加，但神经内膜血管的数量和密度保持相当恒定。在轴索性神经病变病例中，严重的神经病变改变与神经外膜血管数量减少以及神经内膜血管密度同时相对增加有关。未发现（1）神经外膜和神经内膜血管数量之间，以及（2）神经病变的严重程度与神经外膜和神经内膜血管数量或密度之间存在显著相关性。
