老年性痴呆教学ppt课件

《老年性痴呆教学ppt课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、§5Alzheimer’sdiseaseDegenerativedisease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：progressivedementiaCNS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’sdisease（AD)1907AlÖisAlzheimer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’sdisease病因发病不明，4个AD相关基因编码蛋白基因定位APPgenea

2、myloid-proteinprecursor21q11.2-21q22.1ApoE载脂蛋白E19q13-13.2PS1早老蛋白1(Presinilin1)14q24.3PS2早老蛋白21q31-42N端C端细胞外细胞膜细胞内APP非A生成途径P3P7P3CTA生成途径AP7A4CTAPPsAPP水解及A生成模式图Alzheimer’sdisease病理变化肉眼Brainatrophy组织学Neurofibrillarytangles神经原纤维缠结Senileplaques老年斑Amyloidangiopathy淀粉样血管病Granulovacuolar

3、degeneration颗粒空泡变性LossofneuronsInthiscaseofAlzheimer'sdisease,thereismoremarkedatrophyseensuperiorlyandlaterally,withsparingoftheoccipitalregion.178神经原纤维缠结Thisisaneurofibrillary"tangle"ofAlzheimer'sdisease.Thetangleappearsaslongpinkfilamentsinthecytoplasm.Theyarecomposedofcytoskeletalinte

4、rmediatefilaments.098NeurofibrillarychangeAgimpregnationSenileplaqueTheplaquesofAlzheimer'sdiseaseareseenherewithasilverstain.Suchplaquesaremostnumerousinthecerebralcortexandhippocampus.Thisdementiaismarkedmainlybyprogressivememoryloss.091Primaryintracranialtumor:Glioma胶质瘤（40%）Meningioma脑

5、膜瘤（15%）Acousticneurinoma听神经瘤（8%）Metastatictumors:lung,breast§6Tumors分类发病率children:glioma,medulloblastoma髓母细胞瘤Size,location>natureLocaleffectGeneraleffect特点影响Biologic~histologicmalignancyInvasionMetastasistumorDifferentiation分化ClinicalprogressionGeneticchangesI.Astrocytoma星形细胞瘤AstrocytomaA

6、naplasticastrocytoma间变性-Glioblastomamultiforme多形性胶质母细胞瘤atypia,mitoticrate,capillary,endothelialcells,necrosis,hemorrhageAstrocytomaAnaplasticastrocytomaGlioblastomamultiformepoorlydefinedgray-whitesolidmultiform多形性:cyst,necrosis,hemorrhageAstrocytona病变P53mutation/lossofchr.17pLossofchr.22

7、qRbmutation/lossofchr.13qP16deletion/lossofchr.3pLossofchr.19qLossofch.10EGFRgeneamplificationGeneticchangesinastrocytomaNormalastrocyteAstrocytomaAnaplasticastrocytomaGlioblaxtomamultiformeastrocytomaAstrocytomaGlioblatonamultiformeGiantcellsinglioblastomamultiform