文档介绍：§5 Alzheimer’s disease
Degenerative disease
选择性地累及某1~2个功能系统的神经细胞。
老年性痴呆
临床表现:progressive S功能的全面衰退,记忆和认知功能逐渐丧失,直至痴呆而死亡。7~10年以上。
Alzheimer’s disease (AD)
1907 AlÖis Alzheimer 报告:51岁,女性,多疑,记忆力障碍,时间、地点、定向力障碍,4年半后死亡。
目前西方:5% 65岁以上,
上海:3% 65岁以上,% 70岁以上
Alzheimer’s disease 病因发病
不明,4个 AD相关基因
编码蛋白基因定位
APP gene amyloid -protein precursor -
ApoE 载脂蛋白E 19q13-
PS1 早老蛋白1(Presinilin 1)
PS2 早老蛋白2 1q31-42
N 端
C 端
细胞外细胞膜细胞内
APP
非A 生成途径
P3 P7
P3CT
A 生成途径
A P7
A4CT
APPs
APP水解及A 生成模式图
Alzheimer’s disease 病理变化
肉眼
Brain atrophy
组织学
Neurofibrillary tangles 神经原纤维缠结
Senile plaques 老年斑
Amyloid angiopathy 淀粉样血管病
Granulovacuolar degeneration 颗粒空泡
变性
Loss of neurons
In this case of Alzheimer's disease, there is more marked atrophy seen superiorly and laterally, with sparing of the occipital region.
178
神经原纤维缠结
This is a neurofibrillary "tangle" of Alzheimer's disease. The tangle appears as long pink filaments in the cytoplasm. They posed of cytoskeletal intermediate filaments.
098
Neurofibrillary change
Ag impregnation
Senile plaque
The plaques of Alzheimer's disease are seen here with a silver stain. Such plaques are most numerous in the cerebral cortex and hippocampus. This dementia is marked mainly by progressive memory loss.
091
Primary intracranial tumor:
Glioma 胶质瘤(40%)
Meningioma 脑膜瘤(15%)
Acoustic neurinoma 听神经瘤(8%)
Metastatic tumors: lung, breast
§6 Tumors
分类
发病率
children: glioma, medulloblastoma 髓母细胞瘤