基础医学北大病理学课件老年性痴呆.pptVIP

医学课件园 Alzheimer’s disease （AD) 1907 Al?is 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，4.69% 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 21q11.2- 21q22.1 ApoE 载脂蛋白E 19q13-13.2 PS1 早老蛋白1(Presinilin 1) 14q24.3 PS2 早老蛋白2 1q31-42 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 * §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 dementia CNS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。 ? ? ? 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 In this case of Alzheimers 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 Alzheimers disease. The tangle appears as long pink filaments in the cytoplasm. They are composed of cytoskeletal intermediate filaments. 　　　　　　　　　　　　　　　　　　　　098 Neurofibrillary change Ag impregnation Senile plaque The plaques of Alzheimers 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 A 222 Alzheimers neurofibrillary change, basophilic tangles The blue-stained fibrillary bundle extends from the apical dendrite into t