摘要
目的 探讨下肢静脉曲张血管重塑的实质、特征以及在下肢静脉曲张发生机制中的意义。方法 采用Masson染色、免疫组织化学、电镜观察以及图像分析方法研究 1 8例曲张静脉和1 4例正常静脉壁中平滑肌细胞、胶原纤维、Ⅰ型胶原、Ⅲ型胶原和α actin的结构变化。结果 曲张静脉内膜改变以内膜增生为主 ,中膜以中膜增厚为主 ,平滑肌细胞从收缩表型向合成表型转化。α actin在内膜 (3 .67± 0 .69) %和中膜 (1 2 .0 9± 2 .1 4 ) %的体密度比正常静脉 [(8.91± 0 .94) %和(2 1 .42±1 .49) % ]均显著减少 (P <0 .0 1 ) ;Ⅲ型胶原在内膜 (1 4 .1 0± 0 .93) %和中膜 (1 9.58±1 .51 ) %的体密度比正常静脉 [(8.41± 0 .86) %和 (1 2 .97± 1 .1 5) % ]均显著增多 (P <0 .0 1 ) ;I型胶原中膜的体密度 (2 3 .52± 1 .67) %比正常静脉 (1 6 .2 8± 1 .44) %也显著增多 (P <0 .0 1 )。结论下肢静脉曲张血管重塑的平滑肌细胞异常增生 ,从收缩表型向合成表型转化 ,以及细胞外基质中胶原异常改变 ,都使得管壁收缩效应降低 。
Objective To explore the essence of vascular remodeling of varicose veins and the possible signification in etiology of varicose veins in the lower extremities.Methods Smooth muscle cells (SMC),collagen fibres,α smooth mucle actin,typeⅠcollagen and type Ⅲ collagen in 14 normal saphenous veins and 18 varicose saphenous veins were studied quantitatively and qualitatively by the methods of Masson staining,imumohistochemistry,transmission electron microscopy.The image analysis system was applied to quantify the volume density (Vv) of SMC and collagen fibres.Results Intima hyperplasia in the tunica intima and the medial thickening in the tunica medial were the mainly histological apparances of varicose veins associated with transition of SMC from the contractile phenotype to the synthetic phenotype.The Vv of α actin in the intima was different significantly from that in the normal veins [(3.67±0.69)% vs (8.91±0.94)%],and as well as in the medial [(12.09±2.14)% vs (21.42±1.49)%] (both P<0.01).The Vv of type Ⅲ collagen in the intima was significantly increased as compared with that in the normal veins [(14.10±0.93)% vs (8.41±0.86)%] and so was in the medial [(19.58±1.51)% vs (12.97±1.15)%] (both P<0.01).The Vv of type Ⅰ collagen in the medial was also significantly increased as compared with that in the normal veins [(23.52±1.67)% vs (16.28± 1.44)%]. Conclusion Vascular remodeling of varicose veins in the lower extremities is a process that SMCs in the intima and medial proliferats and are transitional from the contractile phenotype to synthetic phenotype, associated with the deposition of the extracellular matrix such as collagen fibres.These changes diminished the contractility of SMCs and led to dilatation of venous wall.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2002年第2期134-136,T004,共4页
Chinese Journal of Experimental Surgery
