CD68-阳性巨噬细胞在人冠状动脉粥样硬化病变中的分布特点及其意义

目的 探讨人冠状动脉粥样硬化病变中CD68-阳性巨噬细胞的分布以及与冠状动脉粥样硬化病变类型、管腔狭窄之间的关系及其意义.方法 选用53例尸检病例的312块冠状动脉组织标本,光镜下诊断弥漫性内膜增厚和冠状动脉粥样硬化病变及其类型,用免疫组织化学计数冠状动脉粥样硬化病变中CD68-阳性巨噬细胞,用Scion图像软件系统检测和计算冠状动脉标本中管腔狭窄程度、脂质坏死核心和钙化基质面积.结果 在冠状动脉粥样病变中, 40% (124/312)为弥漫性内膜增厚, 5% (16/312)为Ⅰ型, 10% (31/312)为Ⅱ型, 21% (66/312)为Ⅲ型, 4% (14/312)为Ⅳ型, 18% (55/312)为Ⅴ型和2% (6/312)为Ⅵ型.脂质坏死核心面积在高胆固醇组明显大于正常胆固醇组(P<0.05),而钙化基质面积在早期病变(Ⅰ～Ⅲ型)和进展期病变(Ⅳ～Ⅵ型)之间有显著性差异(P<0.05);冠状动脉粥样硬化病变CD68-阳性巨噬细胞随着冠状动脉粥样硬化病变进展和管腔狭窄程度的加重而增多,分别呈正相关(P<0.01),且不同病变类型、管腔狭窄程度之间以及正常胆固醇组与高胆固醇组之间有显著性差异(P<0.05).结论 CD68-阳性巨噬细胞随着人冠状动脉粥样硬化病变进展和管腔狭窄程度的加重而增多,表明巨噬细胞浸润始终始发和加重冠状动脉粥样硬化病变,大量巨噬细胞主要在斑块肩部区浸润和脂质坏死核心的增大与冠状动脉粥样硬化病变进展、不稳定性斑块破裂及并发症的发生有关.

Distribution and Significance of CD68-Positive Macrophages in Human Coronary Atherosclerotic Lesion

Aim To study the distribution, correlation and its significance of CD68-positive macrophages with the coronary atherosclerotic lesion types and luminal stenosis in human coronary atherosclerotic lesions.Methods 312 of coronary artery tissue samples were selected in 53 caes of autopsy.Coronary atherosclerotic lesion and its types were di-agnosed by lightm icroscope, and in coronary atherosclerotic lesions, CD68-positive macrophages were counted by using im-munohistochem istry, and the degree of lumen stenosis, area of lipid necrotic core and calcifying matrix were detected and calculated by using the Scion image software systems.Results Area of lipid necrotic core was significantly greater in the high cholesterol group than in the normal cholesterol group (P<0.05), and area of calcifying matrix was significantly different between the early lesions (typeⅠ～Ⅲ) and advanced lesions (typeⅣ～Ⅵ;P<0.05).CD68-positive macro-phages in coronary atherosclerotic lesions were increased with progress of coronary atherosclerotic lesions and aggravation of luminal stenosis, and positive correlation (P<0.01), respectively, and had significant differences among lesion types,and degree of luminal stenosis as well as between normal cholesterol and high cholesterol groups (P<0.05).Conclu-sions CD68-positive macrophages in coronary atherosclerotic lesions are increased with progress of coronary atherosclerotic lesions and aggravation of luminal stenosis, indicating that infiltration of CD68-positive macrophage initiates and aggravates the coronary atherosclerotic lesions, and a large number of macrophages mainly infiltrated in the shoulder area and in-creased lipid necrotic core of plaque, which are associated with progress of coronary atherosclerotic lesions, unstable plaque rupture, and the occurrence of complications in coronary atherosclerosis.