细胞间粘附因子-1在门静脉高压患者脾静脉的表达及意义

目的 探讨细胞间粘附因子—1(ICAM—1)在门静脉高压患者脾静脉的表达及其在贲门周围血管离断术后门静脉血栓形成的意义。方法 对34例门静脉高压患者和34例单纯脾破裂患者的脾静脉行苏木素—伊红染色观察形态学变化；行ICAM—1原位杂交并行定量分析，术后观察门静脉血栓的发生，对两者的关系进行研究。结果 门静脉高压患者脾静脉中膜平滑肌增生，内膜增厚，门静脉高压组和脾破裂组之间脾静脉内皮细胞ICAM—1mRNA表达差异有非常显著性(P＜0．01)；脾破裂组术后无门静脉血栓形成，门静脉高压组有8例门静脉血栓形成；门静脉高压组内有无门静脉血栓形成病例之间脾静脉内皮细胞ICAM—1mRNA表达差异有显著性(P＜0．05)。结论 门静脉高压性血管病变及其内皮细胞ICAM—1mRNA过度表达可能是门静脉高压患者门静脉血栓形成重要原因。

Relationship between Intercelluar adhesion molecule-1 and acute portal vein thrombosis after Pericardial devascularization with splenectomy for the treatment of portal hypertension

Objective To study the mechanism of acute portal vein thrombosis after pericardial devascularization with splenectomy for the treatment of portal hypertension.Methods The expression of intercelluar adhesion molecule-1 was detected by ISH staining in spleen arteries and veins of 34 patients with portal hypertension and controls of splenic rupture.Colored ultrasonic Doppler was used to detect the portal vein thrombosis of all the cases 2 weeks after operation.Results Seven patients with portal hypertension presented portal vein thrombosis.There was significant difference in the expression level of ICAM-1 in the vessels between the patients with portal hypertension and the controls (P<0.01),and between the patients with portal hypertension having portal vein thrombosis and those without portal vein thrombosis (P<0.05).Conclusion Tortal hypertensive vascular lesions and the overexpression of ICAM-1mRNA in spleen vein of patients with portal hypertension might be the important cause for human portal venous thrombogenesis.