老年人巨细胞动脉炎的炎性细胞浸润类型及其分布

目的　研究老年人巨细胞动脉炎的炎性细胞浸润类型及其分布特征。方法　用免疫组织化学技术检测 2 0例巨细胞动脉炎患者颞动脉活检标本T淋巴细胞、B淋巴细胞、巨噬细胞、多核巨细胞和粒细胞表达的情况。以常规HE、美蓝染色及铅铀双重染色 ,在光镜和电镜下观察病理变化 ,比较病理变化与炎性细胞类型及分布的关系。结果　2 0例颞动脉活检标本中 ,浸润的炎性细胞由T淋巴细胞、巨噬细胞和粒细胞构成 ,构成比分别为 40 .5 %、33.5 %和 2 6 .0 %,未见B淋巴细胞和多核巨细胞。炎性细胞分布于颞动脉壁及其周围组织 ,以外膜最明显、内膜次之、中膜居末 ;有明显跳跃现象。炎性细胞分布与病理变化为非比例关系 ,病理损害以内膜明显。结论　老年人巨细胞动脉炎其颞动脉活检标本中可能有较多的粒细胞浸润 ,无多核巨细胞。

Pattern and distribution of inflammatory cell infiltration in giant cell arteritis of the aged

Objective To elucidate the inflammatory cell infiltration types and distribution in temporal artery biopsy specimens from the patients with the diagnosis of giant cell arteritis(GCA) in China and to compare the results with other series.Methods The expression of T cells,B cells,macrophages,giant cells and granulocytes in temporal artery biopsy specimens from twenty patients with GCA was examined using immunohistochemistry.The sections were stained with H&E and methylene blue(MB) for light microscopy (LM),doubly stained with uranyl acetate and lead citrate for electron microscopy (EM) in order to analyze the relation between patterns of inflammatory cell infiltration and pathological changes.Results The immunohistochemistry showed that the inflammatory cell infiltrates of temporal artery biopsy specimens were composed of T cells,macrophages and granulocytes,the ratio of which was 40.5%:33.5%:26.0%,without B cells and giant cells.The inflammatory cell infiltrates in the wall and the tissues surrounding the temporal artery were detected mostly in the adventitia,secondly in the intima and finally in the media.The skip lesions were observed obviously.The changes in the intima,which was out of proportion to the number of inflammatory cell infiltrates,dominated the pathological features.Conclusion In comparison with the results reported in foreign literature,the Chinese GCA patients may get more granulocyte infiltrates without giant cell in temporal artery biopsy specimens.