颈动脉粥样硬化患者中血管平滑肌细胞的变化

目的探讨血管平滑肌细胞(VSMCs)在颈动脉粥样斑块中的数量与分布,为临床分析颈动脉粥样硬化斑块的稳定性提供理论依据。方法对68例颈动脉内膜剥脱术(CEA)患者的斑块,采用Movat染色和免疫组化方法检测斑块中VSMCs,镜下分别统计VSMCs平均积分吸光度值(MA)、单位面积的MA和纤维帽厚度。结果无症状组稳定性和不稳定性斑块发生率为87.5%和12.5%(P<0.001);症状组为25.0%和75.0%(P<0.001)。VSMCs在无症状组和症状组中的MA值分别为1 650±58和1 343±54(P<0.001);在稳定和不稳定性斑块中分别为1 506±59和1 312±58(P<0.05)。无症状组和症状组中VSMCs分布单位面积的MA分别为:基底部1 664±73(MA/mm^2)、1 112±69(MA/mm^2)(P<0.001);肩部1 697±76(MA/mm^2)、1 412±81(MA/mm^2)(P<0.05);纤维帽1 620±65(MA/mm^2)、1 321±66(MA/mm^2)(P<0.01)。随着纤维帽的增厚,VSMCs的单位面积的MA也随之增加,呈正相关性(P<0.001)。结论症状组和不稳定性斑块中VSMCs的数量、密度均少于无症状组和稳定斑块。纤维帽的厚度与VSMCs的密度呈正相关性。

Changes of vascular smooth muscle cells in patients with carotid atherosclerosis

Objective To explore the vascular smooth muscle cells(VSMCs) counting and distribution in carotid atherosclerotic plaque and thus provide theoretical basis for clinical analysis of carotid atherosclerotic plaque stability. Methods Totally 68 patients with carotid artery plaque after CEA were collected. All the surgical specimens were stained with Movat and immunochemistry to detect VSMCs, and the MA , MA /mm 2 and the thickness of fibrous cap was counted by the microscopy. Results The stable and unstable plaques were 87.5% and 12.5% in the asymptomatic group, 25.0% and 75.0% in the symptomatic group, respectively ( P <0.001). MA of VSMCs in asymptomatic and symptomatic groups was 1 650±58, 1 343±54 ( P <0.001);1 506±59, 1 312±58 in stable and unstable plaques, respectively ( P <0.05). For distribution, the asymptomatic group and the symptomatic group were (1 664±73) MA /mm 2,(1 112±69) MA /mm 2 in basal part ( P <0.001),(1 697±76) MA /mm 2,(1 412±81) MA /mm 2 in the shoulder part ( P <0.05),(1 620±65) MA /mm 2,(1 321±66) MA /mm 2 in the fibrous cap ( P <0.01), respectively. With the increase of fibrous cap, MA /mm 2 of VSMCs also increased in both groups, showing a significant positive correlation ( P <0.001). Conclusions The quantity and density of VSMCs in symptomatic and unstable plaques are less than those in asymptomatic and stable plaques. The thickness of fibrous cap is positively correlated with the density of VSMCs.