Nadaj-Pakleza Aleksandra, Kierdaszuk Biruta, Kamińska Anna
Biruta Kierdaszuk, Katedra i Klinika Neurologii, Warszawski Uniwersytet Medyczny, ul. Banacha 1a, 02-097 Warszawa.
Neurol Neurochir Pol. 2010 Sep-Oct;44(5):481-91. doi: 10.1016/s0028-3843(14)60139-0.
Muscle biopsy is required to provide a definitive diagnosis in many neuromuscular disorders. Biopsy findings may indicate whether the pathological process is of neurogenic or myopathic origin. The muscle biopsy may give important information on the course of the disease (acute or chronic) and on the disease stage and progression. The interpretation of muscle biopsy, including histochemical and ultrastructural analysis, is a key factor in the diagnosis of muscular dystrophies, glycogenoses, inflammatory myopathies and congenital myopathies. An assessment of muscle biopsy on electron microscopy enables a definite diagnosis of oculopharyngeal muscular dystrophy, mitochondrial myopathy or inclusion body myositis. This paper presents an overview of general indications for muscle biopsy, biopsy procedures, as well as transportation and preparation of muscle tissue for final microscopic analysis. The interpretation of specific microscopic findings and a brief discussion on the clinical usefulness of muscle biopsy in the era of molecular diagnosis are also presented.
在许多神经肌肉疾病中,需要进行肌肉活检以提供明确诊断。活检结果可能表明病理过程是神经源性还是肌源性的。肌肉活检可以提供有关疾病病程(急性或慢性)、疾病阶段和进展的重要信息。对肌肉活检进行解释,包括组织化学和超微结构分析,是诊断肌肉营养不良症、糖原贮积病、炎性肌病和先天性肌病的关键因素。通过电子显微镜对肌肉活检进行评估能够明确诊断眼咽型肌营养不良症、线粒体肌病或包涵体肌炎。本文概述了肌肉活检的一般适应证、活检程序,以及用于最终显微镜分析的肌肉组织的运输和制备。还介绍了特定显微镜检查结果的解读以及在分子诊断时代肌肉活检临床应用的简要讨论。