曲张大隐静脉管壁病理改变与临床病期的关系

目的研究曲张大隐静脉管壁病理改变与临床分期的关系,为临床治疗提供依据。方法收集不同临床分期的曲张大隐静脉上、中、下三段管壁标本,制作切片分别在光镜和电镜下进行观察。结果光镜下上、中、下三段均出现管壁厚薄不一,内膜增厚不均匀,中膜平滑肌排列紊乱,弹力纤维分离变性、胶原纤维不规则增生、平滑肌增生、萎缩等改变。电镜下上、中、下三段平滑肌细胞胞浆内粗面内质网、核糖体和线粒体等细胞器较多,肌丝较少,中、下段平滑肌有细胞器形态的改变。结论大隐静脉曲张时静脉管壁光镜下全程的病理改变相似,而电镜下血管壁上、中、下三段平滑肌细胞器的改变不同,但其变化与临床分期无关。

The study of the relationship between pathologic change of vessel wall and clinical stage in great saphenous varicose

Objective To study the relationship between pathologic change of vessel wall and clinical stage in great saphenous varicose(GSV), so as to provide evidence for clinical treatment.Method Specimens collected from the proximal thigh great saphenous vein(GSV),the below knee and the distal calf blowouts of varicose great saphenous vein in different stage were made of the sections to be observed under the light and the transmission electron microscope(TEM).Result Under light microscope, the three segments all showed varying in thickness of vessel wall, asymmetric increase in intimal, disorder arrangement of the medial smooth muscle,disconnection and degeneration of elastic fiber, abnormal hyperplasia of collagenous fiber, hyperplasia and atrophy of the smooth muscle in varicose veins compared with normal veins.Under transmission electron microscope, the three segments all showed more organelles, such as rough endoplasmic reticulum, ribosome, mitochondria in cytoplasm of smooth muscle cell, fewer myofilaments, and morphological changes of some organelles in the below knee and the distal calf blowouts.Conclusion Similar pathologic changes of vessel wall occurred on all of the GSV and are not related with clinical stage.