Becker L E, Takashima S
Neuropediatrics. 1985 Feb;16(1):19-23. doi: 10.1055/s-2008-1052538.
Chronic hypoventilation is important in the pathogenesis of congenital hypoventilation syndromes and sudden infant death syndrome. Cases of hypoventilation can be divided clinically into those with a defective respiratory drive and those with mechanical impairment of either the lungs or the chest wall. To determine the relationship between chronic hypoventilation and brain stem gliosis, the development of astrocytes in the brain stem of normal and abnormal cases with either type of chronic hypoventilation was studied morphometrically. The glial fibrillary acidic protein immunoperoxidase method of staining astrocytes showed a transient increase of astrocytes in some parts of the brain stem during early infancy in thirty-five normal cases. The astrocytosis was even greater in both types of chronic hypoventilation including subjects with myopathy, Ondine's curse, and sudden infant death syndrome. Gliosis in these subjects may have resulted from "asphyxia" of the brain stem, as seen in cases with myopathies involving respiratory muscles. However, the involvement of brain stem respiratory centers may suggest a failure of neural respiratory control that further compromises respiratory function.
慢性通气不足在先天性通气不足综合征和婴儿猝死综合征的发病机制中具有重要意义。通气不足的病例在临床上可分为呼吸驱动缺陷型和肺部或胸壁机械性损伤型。为了确定慢性通气不足与脑干胶质增生之间的关系，我们采用形态计量学方法研究了正常及异常慢性通气不足病例脑干中星形胶质细胞的发育情况。用胶质纤维酸性蛋白免疫过氧化物酶法对星形胶质细胞进行染色，结果显示，在35例正常病例的婴儿早期，脑干某些部位的星形胶质细胞出现短暂增加。在包括肌病、翁丁氏咒诅综合征和婴儿猝死综合征在内的两种慢性通气不足类型中，星形细胞增生更为明显。这些受试者的胶质增生可能是由于脑干“窒息”所致，如在涉及呼吸肌的肌病病例中所见。然而，脑干呼吸中枢的受累可能提示神经呼吸控制功能衰竭，进而进一步损害呼吸功能。
