【作者】 李静；

【导师】 孙雷；

【作者基本信息】 大连医科大学 ， 病理学与病理生理学， 2005， 硕士

【摘要】 目的 巨噬细胞浸润在动脉粥样硬化斑块的构成、发展和破裂的过程中占有重要的作用,严重者这一过程可导致急性冠脉综合症。本研究评估内膜巨噬细胞的浸润与冠状动脉进行性狭窄的关系,以及与巨噬细胞的浸润相关的趋化因子(MCP-1)和核因子(NF-κB)它们在巨噬细胞浸润过程中所起到的作用。 方法 从 39 例尸检标本中获得 39 个冠状动脉左前降支的标本。应用弹力纤维染色及电脑软件分析系统,测量其狭窄程度,并根据其狭窄程度将其分为 3 组(A 组:〈50%;B 组:50%-75%;C 组:〉75%)。根据炎细胞浸润到外膜、中膜和内膜的程度和数量,我们将炎症反应分为 5 级,即 G-0 到 G-IV。免疫组织化学的方法用来检测巨噬细胞( CD68 ), 检 测 单 核 细 胞 趋 化 蛋 白 - 1 ( Monocyte chemotacticprotein-1,MCP-1)和核因子-kappa B(Nuclear factor-kappa B,NF-κB)在冠状动脉局部组织中的表达情况。 结果 我们发现血管进行性狭窄有明显的粥样斑块的形成,显示 C组的斑块面积大于 B 组的斑块面积(P<0.001),然而在 A 组没有粥样斑块形成。粥样斑块形成过程中伴有明显的炎症反应及大量巨噬细胞浸润(C 组>B 组>A 组)。三组内膜面积与中膜面积的比值 B 组和 C 组明显大于 A 组(P<0.001),而三组中膜面积无显著性差异。B 组与 C 组更多还原

【Abstract】 Macrophages play an important role in atherosclerotic plaqueformation, progression and rupture, which are responsible for the majorityof acute coronary syndromes. This study was to assess the relationshipbetween intimal macrophage infiltration and the progressive stenosis incoronary arteries. And at the same time we examined the relationshipbetween the MCP-1 and NF-κB expression and macrophage infiltration. Thirty-nine left anterior descending coronary arteries in 39 autopsiedcases were enrolled. The arteries were analyzed and divided into 3 groupsaccording to the degree of stenosis (group A: < 50% stenosis; group B:50% ~75% stenosis; group C: >75% stenosis). Inflammatory response wasgraded from G-0 to G-4 according to inflammatory cell infiltration inadventitia, media and intima. Immunohistochemistry was used to visualizethe presence of macrophages (CD68) and to examine the MCP-1 andNF-κB expression, so that we can find the relationship betweenmacrophage infiltration and these cytokines. Vascular progressive stenosis with significant atherosclerotic plaqueformation was recognized, showing plaque area in group C larger than ingroup B (p<0.001), while there was no plaque in group A. Inflammatoryresponse was related to the degree of vascular stenosis and plaqueformation. Significant macrophage infiltration in intima was recognized ingroup B and C, mainly appearing in the plaque area. Ratio of IT/media indifferent groups had obvious difference (group B and group C versus groupA, p<0.0001). But there was no difference in the cross sectional area ofmedia. According to the percent of the plaque in the intima, we dividedgroup B and group C into two sub-groups respectively, B1 and B2sub-groups, C1 and C2 sub-groups. Then we found the plaque area andmacrophages counting of B2 and C2 are obvious larger than B1 and C1(p<0.0001 and p<0.00001, respectively). About the macrophage countingin three groups, we found the group B and C is much more than group A.MCP-1 immunoreactivity was found strongly in atherosclerotic plaque ofgroup B and group C, and the same result was found in NF-κB. And therewas positive relationship between MCP-1 and NF-κB. Our study has demonstrated that coronary artery progressive stenosisis caused by intimal hyperplasia. Plaque is the most capital component ofthe intima. Macrophage infiltration in arterial intima plays an importantrole in coronary artery progressive stenosis by plaque formation. MCP-1and NF-κB might regulate this progression. We concluded that the degreeof luminal stenosis much more related to the macrophage infiltration andplaque formation.更多还原