人冠状动脉粥样硬化斑块内细胞成分与斑块稳定性的关系
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人冠状动脉粥样硬化斑块内细胞成分与斑块
稳定性的关系
作者:郭爱桃,石怀银,韦立新,孙璐
【关键词】动脉硬化
Relationship between cell components in human coronary atherosclerosis plaque and stability of plaque
【Abstract】 AIM: To evaluate the relationship between the plaque stability and the cell components in human coronary atherosclerosis plaque and to investigate the interrelation of cell components. METHODS: One hundred and twentyfive cases of coronary cardiac diseases including acute myocardial infarction, unstable angina and stable angina, who died in recent 12 years and had full data, were selected. The coronary arteries of each case were transversely cut, embedded and stained with HE. After observing and analyzing the morphologic features, parts of the coronary artery segments were selected for immunohistochemical staining of 6 markers against αsmooth muscle actin (SMA), CD20, CD3, CD68, HLADR and mast cell tryptase. RESULTS: More macrophages, T lymphocytes and mast cells were observed
infiltrated in unstable plaque and smooth muscle cells were more common in stable plaque. A significant negative correlation was found between the expression of SMA and CD68, CD3, tryptase. CONCLUSION: The decrease in the number of smooth muscle cells and the increase in the number of macrophages, T lymphocytes and mast cells may be the major pathologic mechanism responsible for plaque instability. The infiltration of macrophages, T lymphocytes and mast cells is closely related to the decrease of smooth muscle cells in plaque.
【Keywords】arteriosclerosis; unstable plaque; T lymphocytes; macrophages; myocytes, smooth muscle; mast cells
【摘要】目的:探讨人冠状动脉粥样硬化斑块内细胞成分与斑块稳定性之间的关系,以及各种细胞成分之间有无必然的联系. 方法:选取解放军总医院近12年间具有完整资料的急性心肌梗死、不稳定心绞痛和稳定心绞痛尸体解剖病例共125例,对每一例的全部冠状动脉进行取材制片,观察分析形态学指标,并从中挑选一部分蜡块切片行免疫组化染色(包括: SMA, CD3, CD68,CD20, HLADR, mast cell tryptase). 结果:免疫组化标记不稳定斑块组SMA的表达明显低于稳定斑块组,而CD68, CD3和mast cell tryptase的表达正好相反(P<0.05);SMA的表达与CD68, CD3和mast cell tryptase的
表达呈明显负相关关系. 结论:斑块内平滑肌细胞明显减少,巨噬细胞、T淋巴细胞和肥大细胞显著增高,可能是导致斑块不稳定的主要病理学机制;斑块内平滑肌细胞数量减少与巨噬细胞、T淋巴细胞和肥大细胞浸润密切相关.
【关键词】动脉硬化;不稳定斑块;T淋巴细胞;巨噬细胞;肌细胞,平滑肌;肥大细胞
0引言
冠状动脉粥样硬化斑块破裂并触发血栓形成是导致急性冠状动脉综合征的重要机制,斑块是否破裂主要取决于斑块的稳定性,斑块自身的组织结构与斑块的稳定性关系非常密切[1,2]. 由于冠状动脉粥样硬化的动物模型复制不理想以及人体材料来源困难,国内采用人体材料对斑块中的各种细胞成分的数量及功能状态与斑块稳定性关系的研究很少[3],我们收集我院12年来125例冠心病尸检材料,应用免疫组化对斑块内各种细胞成分进行定性和定量研究,探讨这些细胞与斑块稳定性的关系,以及各种细胞成分相互之间的作用机制.
1材料和方法
1.1材料