巨噬细胞浸润与钙化性主动脉瓣狭窄关系的研究

发布时间：2018-05-30 10:14

本文选题：钙化性主动脉瓣狭窄 + 巨噬细胞　；参考：《华中科技大学学报(医学版)》2015年04期

【摘要】：目的探讨巨噬细胞与老年钙化性主动脉瓣狭窄(calcific aortic valve stenosis,CAVS)程度的关系。方法收集2012年9月至2014年3月在海南省人民医院心脏外科因CAVS行手术切除的严重钙化主动脉瓣标本80例[男40例,女40例,年龄(58±6)岁],另外取因夹层动脉瘤行手术切除正常主动脉瓣标本7例[男4例,女3例,年龄(41±8)岁],选择80例健康成人作为对照组,收集患者的临床基本资料,苏木精-伊红(HE)染色观察CAVS瓣膜病理组织学改变;免疫组织化学(IHC)染色观察巨噬细胞的表达特点;IPP(Image-Pro Plus)软件测量巨噬细胞密度,Pearson相关分析探索巨噬细胞密度与瓣膜狭窄程度的相关性。结果与对照组比较,CAVS患者血清胆固醇和C反应蛋白水平升高,差异有统计学意义,HE染色可见CAVS瓣膜损伤部位有炎性细胞浸润、新生毛细血管和钙化灶形成。IHC染色观察,巨噬细胞标志CD68在正常主动脉瓣膜无阳性表达,而在CAVS瓣膜中呈阳性表达,分布在钙化灶以及骨样组织周围;相关分析表明巨噬细胞最大密度值与瓣口压力阶差峰值(r=0.75,P0.05)、平均压力阶差(r=0.75,P0.05)、主动脉瓣口流速峰值(r=0.72,P0.05)呈正相关,而与瓣口面积呈负相关(r=-0.71,P0.05)。结论与对照组比较,CAVS患者血清胆固醇和C反应蛋白浓度升高;与正常瓣膜比较,CAVS瓣膜中巨噬细胞浸润,巨噬细胞密度与钙化性主动脉狭窄程度呈正相关。
[Abstract]:Objective to investigate the relationship between macrophages and the degree of calcific aortic valve stenosisus (CAVS) in elderly patients with calcified aortic valve stenosis. Methods from September 2012 to March 2014, 80 patients (40 males and 40 females) with severe calcified aortic valve treated by CAVS in the Department of Cardiac surgery, Hainan Provincial people's Hospital, were collected. In addition, 7 normal aortic valve specimens (male 4, female 3, age 41 卤8) due to dissecting aneurysm were selected as control group, 80 healthy adults were selected as control group, and the basic clinical data of the patients were collected. The histopathological changes of CAVS valves were observed by hematoxylin and eosin HEV staining. The expression of macrophages was observed by immunohistochemical staining. Pearson correlation analysis was used to study the correlation between macrophage density and the degree of valve stenosis. Results compared with the control group, the serum cholesterol and C-reactive protein levels in CAVs patients were higher than those in the control group. The difference was statistically significant (P < 0.05). The inflammatory cell infiltration, the formation of new capillaries and calcification foci of CAVS valve were observed by HE staining, and the formation of calcification foci was observed by .IHC staining. Macrophage marker CD68 showed no positive expression in normal aortic valve, but positive expression in CAVS valve, distributed around calcified lesion and bone like tissue. The correlation analysis showed that the maximum density of macrophages was positively correlated with the peak value of valve pressure order (r = 0.75), the mean pressure order (n = 0.75), and the peak velocity of aortic valve (n = 0.72, P 0.05), but negatively correlated with the area of valve orifice (r = -0.71, P = 0.05). Conclusion compared with the control group, serum cholesterol and C-reactive protein concentrations in CAVS patients increased, and macrophage infiltration and macrophage density were positively correlated with calcified aortic stenosis.
【作者单位】：华中科技大学同济医学院附属协和医院超声科;海南省人民医院心脏外科;
【分类号】：R654.2;R445.1

【参考文献】