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目的对顽固性颞叶癫疒间病人的海马癫疒间灶组织和癫疒间灶周围正常组织的超微结构进行形态定量观察,以探讨颞叶癫疒间的发生机制。方法对45例病人在深部电极监测下手术切除海马,电镜观察癫疒间灶组织和癫疒间灶周围正常组织中锥体细胞和突触结构的形态学变化;采用体视学分析颞叶癫疒间灶组织和癫疒间灶周围正常组织锥体细胞线粒体体积密度(Vv)、面积密度(Sv)、数密度(Nv)、比表面积(δ)、平均体积(V);测量突触间隙的宽度。结果癫疒间灶组织锥体细胞线粒体较癫疒间灶周围正常组织明显肿胀,且嵴断裂,数量减少,平均截面积增大;线粒体的Vv、V较癫疒间灶周围正常组织大,Sv、Nv、δ较癫疒间灶周围正常组织小。癫疒间灶组织中锥体细胞的轴突和树突内线粒体较癫疒间灶周围正常组织的锥体细胞肿胀明显;轴棘、轴树突触间隙宽度变窄。结论海马锥体细胞超微结构的改变和细胞线粒体功能变化与顽固性颞叶癫疒间的发生关系密切。
Objective To investigate the ultrastructure of hippocampal epileptic foci in patients with intractable temporal lobe epilepsy and normal tissues around the epileptic foci in order to explore the mechanism of temporal lobe epilepsy. Methods Forty-five patients underwent surgical resection of the hippocampus under deep electrode monitoring. Morphological changes of pyramidal cells and synaptic structures in epileptic foci and normal tissues around the epileptic foci were observed under electron microscope. Temporal lobe epilepsy (Vv), area density (Sv), number density (Nv), specific surface area (δ), average volume (V) of mitochondria in normal tissue around the epileptic foci and epileptic foci; The width of Results The mitochondria of pyramidal cells in the epileptic foci were obviously swollen compared with the normal tissues around the epileptic foci. The number of cristae was reduced and the average cross-sectional area increased. The Vv and V of mitochondria were larger than that of normal tissues around the epileptic foci, , Nv, δ is smaller than the normal tissue around the epileptic foci. In the epileptic foci, the axons of the pyramidal cells and the mitochondria in the dendrites swell more than those in the normal tissues around the epileptic foci. The width of the synaptic cleft between the axial spine and the axons is narrowed. Conclusion The ultrastructural changes of hippocampal pyramidal cells and the changes of mitochondrial function are closely related to the intractable temporal lobe epilepsy.