含血栓静脉管壁病理形态学特征的比较性研究

目的 探讨含血栓的静脉管壁病理形态学特征及管腔内径变化.方法 收集含血栓的曲张大隐静脉主干标本18例(血栓组),单纯曲张大隐静脉主干标本18例(曲张组),另设正常大隐静脉主干标本12例(对照组).采用苏木精-伊红和Masson染色法,观察管壁组织结构,测量血管壁内径与内膜、中膜、外膜厚度.结果 血栓组管壁全层及血栓内见大量炎细胞浸润,血栓附着处内皮细胞缺失,大量增生的胶原纤维自破裂内膜处延伸至血栓内致部分血栓机化.曲张组管壁全层偶见炎细胞,内膜增厚,中膜平滑肌细胞不规则增生,排列紊乱,胶原纤维增生.对照组管壁内膜薄,中膜平滑肌束排列规则.血栓组管腔内径、内膜厚度、中膜厚度和外膜厚度与曲张组、对照组比较差异均有统计学意义(P＜0.05),曲张组管腔内径和内膜厚度与对照组比较差异有统计学意义(P＜0.05).结论 含血栓的曲张静脉管腔增大、管壁增厚是病理形态学改变的主要特征.

Comparative study on pathomorphological features of varicose veins wall with thrombus

Objective To investigate the changes of pathomorphological features and lumen diameter of varicose great saphenous veins wall with thrombus. Methods Eighteen cases of varicose great saphenous veins with thrombus(thrombus group), 18 cases of simple varicose veins(varicose group), and 12 cases of normal great saphenous veins (control group) were collected. Using hemotoxylin and eosin staining and Masson staining, the wall structure was observed, and the vein diameter and the thickness of the inner, middle and outer membranes were measured. Results In thrombus group, a large number of inflammatory cells were observed in full-thickness of venous wall, endothelial cells were lost on adhesion of thrombus, and partal thrombus organization was caused by a lot of collagen fibers extending from rupture of intima to introthrombus. In varicose group,inflammatory cells were observed occasionally in full-thickness of venous wall, intimal thickened, smooth muscle cells in mid layer were proliferated irregularly and disordered, and collagen fibers proliferated. In control group, intima of venous wall was thin, the medial smooth muscle bundles was regular on arrangement. The lumen diameter, the thickness of the inner,middle and outer membranes thrombus group were significantly higher than that of varicose group and control group (P<0.05), while the lumen diameter and intima thickness of varicose group were significantly higher than that of control group(P<0.05). Conclusion Lumen increasing and wall thickening are important features of path morphological changes.