纤维蛋白沉积与静脉性溃疡形成的研究

以26例下肢静脉瓣膜关闭功能不全患者和15例正常者为对象,通过局部皮肤病理和超微结构观察,下肢静脉血tPA、PAI:检测发现1.静脉性溃疡及皮肤色素沉着区皮下毛细血管周围纤维蛋白沉积伴成纤维细胞钙盐沉着,坏死;2.患者皮肤营养障碍越严重,tPA越低,PAI越高,即纤溶活性越弱。结果表明:下肢静脉功能不全患者毛细血管周围纤维蛋白沉积形成的弥散屏障是静脉性溃疡形成的主要因素;血液纤溶活性降低造成的清除纤维蛋白能力减退加重了该病理过程。两者导致皮肤营养障碍性改变,直至溃疡形成。

Fibrin Deposition and Venous Ulceration

Twenty six patients with venous insufficiency and 15 normal controls were studied by examining the histopatthological and ultrastructural changes of the overlying local skin and measuring the venous blood tPA and PAl. The results demonstrated that: (1) Biopies from the ulcerative and liposclerotic areas showed pericapillary fibrin deposition accompanied by calcium deposition in and necrosis of the fibroblasts. (2) The more marked the skin changs in patients with venous insufficiency, the weaker the fibrinolytic activity. It was concluded that: Extravascular deposition of fibrin blocking the diffusion and exchange of oxygen between the blood and tissue was the most important factor in the development of venous ulceration. The decrease of fibrinolytic activity incurred the decrease of removing the pericapillary fibrin deposition, and in combination with extravascular fibrin caused the venous ulceration.