【摘要】 背景:目前关于心脏、大血管疾病的血管重塑及其病理学、分子生物学、免疫组织化学以及药物对血管重塑的影响有大量的研究报道,而对于精索静脉曲张的有关报道较少。目的:观察精索静脉曲张过程中管壁肌动蛋白和胶原的定性与定量的变化。设计、时间及地点:同期非随机对照观察,于2006-03/2007-06在重庆医科大学附属第一医院泌尿外科完成。对象:实验组精索静脉取自2006-03/2007-06在重庆医科大学附属第一医院泌尿外科接受手术治疗的精索静脉曲张患者30例;年龄(26.29±9.12)岁;病程(2.76±1.83)年。对照组选取同期该科肾移植供体正常精索静脉,共24例,年龄(39.56±8.32)岁。患者及供体亲属对治疗完全知情同意。方法:采用V-G染色、免疫组织化学、扫描电镜定性和定量观察30例曲张精索静脉和24例正常精索静脉壁中肌动蛋白及胶原纤维变化,并进行图像分析。主要观察指标:两组精索静脉平滑肌细胞、胶原纤维、Ⅰ型胶原、Ⅲ型胶原和α-肌动蛋白的变化及吸光度和面密度的变化。结果:①曲张精索静脉内膜、中膜改变以增厚为主,平滑肌细胞从收缩表型向合成表型转化。②曲张静脉α-肌动蛋白的吸光度和面密度均比正常静脉增多(P<0.01);曲张静脉Ⅰ型胶原及Ⅲ型胶原的吸光度和面密度均比正常静脉增多(P<0.01)。结论:精索静脉曲张管壁的平滑肌细胞异常增生,从收缩表型向合成表型转化,细胞外基质中胶原异常改变,可能是精索静脉曲张发生和发展的机制之一。更多还原

【Abstract】 BACKGROUND: At present, there are considerable investigations and reports concerning the vascular remodeling cum pathology, molecular biology, immunohistochemistry, drug effect to the disease of the heart and great vessels. But varicocele is seldom reported. OBJECTIVE: To observe the change of the qualitation and quantitation of actin and collagen in varicocele vessel wall. DESIGN, TIME AND SETTING: A synchronized non-randomized control observation was carried out in the Department of Urinary Surgery, the First Affiliated Hospital of Chongqing University of Medical Sciences from March 2006 to June 2007. PARTICIPANTS: Thirty varicocele patients treated in Department of Urinary Surgery, the First Affiliated Hospital of Chongqing University of Medical Sciences from March 2006 to June 2007, were recruited for experimental group in this study. Their age was (26.29±9.12) years, and the course of disease was (2.76±1.83) years. Meanwhile, 24 normal spermatic veins from the donator of kidney transplantation, aged (39.56±8.32) years, were served as control group. All the patients and the donators’ relatives signed the informed consent to the treatment. METHODS: Changes of collagen fibers and actin in 24 normal spermatic veins and 30 varicocele veins were studied quantitatively and qualitatively by the methods of V-G staining, immunohistochemistry, and scanning electron microscopy. The image analysis was conducted. MAIN OUTCOME MEASURES: Changes of smooth muscle cells (SMC), collagen fibers, type Ⅰ collagen, type Ⅲ collagen and α-smooth muscle actin, as well as optical density and area density. RESULTS: ①Tunica intima hyperplasia and medial thickening were the main histological appearances of varicocele veins, SMC transformed from the contractile phenotype to the synthetic phenotype.②The optical density and area density of α-actin, type Ⅰ collagen and type Ⅲ collagen were increased significantly compared with the normal veins (P < 0.01). CONCLUSION: The development of varicocele may be associated with paraplastic SMC transforming from the contractile phenotype to the synthetic phenotype, and the abnormal change of collagen in the extracellular matrix.更多还原