老年高血压伴主动脉夹层患者临床及病理分析

目的探讨老年高血压伴主动脉夹层临床表现与病理特点。方法选择15例老年高血压伴主动脉夹层患者为夹层组,同期选择高血压未伴主动脉夹层15例患者为对照组,取入选患者的尸体解剖病理切片,回顾性分析2组临床表现、病理特点及免疫组织化学检测状况。结果与对照组比较,夹层组患者临床表现复杂多样,病理特点为夹层壁内平滑肌细胞明显退行性变,弹力纤维减少或断裂,胶原纤维增生,夹层壁内血管第八因子相关抗原表达增强,平滑肌肌动蛋白表达降低。结论高血压伴主动脉夹层是严重威胁老年人生命的一种并发症。严格控制血压,是预防老年人主动脉夹层发生的重要手段。

Clinical and pathological analysis of elderly patients wilh hypertension accompanying aortic dissection

Objective To study the clinical manifestations and pathological features of hypertension accompanying aortic dissection in the elderly.Methods Fifteen old patents with hypertension accompanying aortic dissection served as aortic dissection group and 15 patients with hypertension not accompanying aortic dissection served as control group.Tissue samples were taken from the enrolled patients at autopsy and cut into sections.Clinical manifestations,pathological features, and immunohistochemical findings in two groups were retrospectively analyzed.Results The clinical manifestations of aortic dissection were more complicated in aortic dissection group than in control group,which were characterized by significant retrograde degeneration of smooth muscle cells in aortic dissection wall,less or broken elastic fibers,proliteration of collagen fibers,increased expression of factorⅧ-related antigens and decreased expression of smooth muscle actin in blood vessels of aortic dissection wall.Conclusion Hypertension accompanying aortic dissection is a severe complication threatening the life of old people.Rigid control of blood pressure is an important measure to prevent the occurrence of aortic dissection in the elderly.