Brasileiro-Filho G, Guimaraes R C, Pittella J E
Departamento de Anatomia Patologica, Faculdade de Medicina, UFMG, Belo Horizonte-MG, Brazil.
Acta Neuropathol. 1989;77(6):582-90. doi: 10.1007/BF00687885.
A morphological, karyometric, and quantitative study of cerebral neuroglia and endothelial cells of blood capillaries was done in cirrhotic and in hepatosplenic schistosomotic human autopsied cases. Cluster analysis applied to them revealed three subgroups (cirrhosis and schistosomiasis polar groups and one intermediate). The comparison of these three groups with a control revealed increased numbers of astrocytes, oligodendrocytes and endothelial cells, but no nuclear enlargement in the schistosomiasis group; the cirrhosis group exhibited a pronounced nuclear enlargement of both astrocyte and oligodendrocytes but no increase in cell numbers. The intermediate group, which encompasses the majority of pathological cases, is heterogeneous but on average behave as the cirrhosis group in that nuclear enlargement, but no increase in cell numbers, was noted. Such changes could represent a response of the nervous system to the metabolic disturbances present in hepatic and/or portal-systemic encephalopathy. There was a positive correlation between glial and endothelial cell numbers in cerebral cortex, suggesting a functional relationship between the glial cells and the capillary bed. This study points out the importance of clustering the cases, because the physiopathological status of individuals belonging to the same nosological condition can be different. Comparisons considering this aspect should be useful in understanding the progression of the pathological process.
对肝硬化和肝脾血吸虫病患者的尸检病例进行了大脑神经胶质细胞和毛细血管内皮细胞的形态学、核测量学及定量研究。对这些病例进行聚类分析后发现了三个亚组(肝硬化和血吸虫病两极组以及一个中间组)。将这三组与对照组进行比较发现,血吸虫病组的星形胶质细胞、少突胶质细胞和内皮细胞数量增加,但细胞核未增大;肝硬化组的星形胶质细胞和少突胶质细胞均出现明显的核增大,但细胞数量未增加。包含大多数病理病例的中间组具有异质性,但平均表现与肝硬化组相同,即细胞核增大,但细胞数量未增加。这种变化可能代表神经系统对肝性和/或门体性脑病中存在的代谢紊乱的一种反应。大脑皮质中神经胶质细胞和内皮细胞数量之间存在正相关,表明神经胶质细胞与毛细血管床之间存在功能关系。这项研究指出了病例聚类的重要性,因为属于同一病种的个体的生理病理状态可能不同。考虑到这一方面的比较对于理解病理过程的进展应该是有用的。