Болезнь Альцгеймера

Эта болезнь вызывает слабоумие. Она медленно убивает более 100 тыс. человек за год в одних только Соединенных Штатах Америки. Неизвестны ни ее причины, ни средства остановить ее безжалостное течение. Существует шесть разных гипотез о механизме заболевания

КАЖДЫЙ год несколько сотен тысяч американцев начинают утрачивать свою способность запомнить, выключили ли они кухонную плиту и закрыли ли входную дверь. Им становится трудно назвать привычные вещи, найти нужное слово или подсчитать деньги. Они все еще неплохо выглядят внешне, у них не обнаруживается ни явных неврологических расстройств, ни глубокой депрессии, ни опухоли мозга, они не перенесли инсульта и не страдают какой-нибудь другой известной болезнью, способной вызвать такие симптомы. И все же эти люди тяжело больны. Пройдет 3—10 лет, и они станут совсем слабоумными, по существу лишатся рассудка. Они не смогут говорить, думать, следить за собой, а в конце концов скончаются от осложнений, которыми страдают прикованные к постели больные.

Чаще всего болеют пожилые люди, однако наблюдающиеся у них симптомы — не просто следствие старения как такового. Они страдают вполне определенным заболеванием — болезнью Альцгеймера. Этот диагноз ставится только на основании длительного наблюдения; нет ни характерной картины аномалий в поведении, ни удовлетворительного лабораторного теста, кроме биопсии мозга. Лишь посмертное вскрытие выявляет специфические патологические изменения в мозгу.

Во-первых, наблюдается гибель нейронов (нервных клеток), особенно в областях, важных для памяти и способности к обучению, т.е. для процессов мышления. Во-вторых, внутри нейронов появляются скопления скрученных филаментов (нейрофибриллярные клубки) и другие аномальные структуры. В-третьих, обнаруживаются аморфные агрегаты белка (амилоид) вокруг кровеносных сосудов и внутри них. Наконец, наблюдаются рассеянные очаги амилоида и обломков клеток, называемые амилоидными тельцами, или сенильными бляшками. (Подобные изменения находят также в мозгу старых людей, не страдающих деменцией, т.е. слабоумием. Однако у них, в каждом отдельном случае, присутствуют обычно не все эти признаки и выражены они не так ярко.) Кроме того, наблюдается заметная гибель нейронов в некоторых более примитивных областях в нижних отделах мозга, вследствие чего уменьшается количество медиаторов (химических посредников передачи нервных импульсов), особенно ацетилхолина, которые в норме выделяются окончаниями этих нейронов, находящимися в высших мозговых центрах.

 

 

 

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