血清IgE增高的青年缺血性卒中患者颞动脉组织病理学研究

发布时间：2018-08-23 19:33

【摘要】：目的临床上部分青年缺血性卒中患者血清免疫球蛋白E(immunoglobulin E,Ig E)增高,推测为脑血管炎,但缺乏病理学依据。文中旨在通过颞动脉活检组织病理学研究探讨该类患者血管病变的特点。方法对2013年1月至2015年8月间在南京军区南京总医院神经内科住院的32例病因不明的青年缺血性卒中患者颞动脉标本进行组织病理学检查,其中血清Ig E正常者(正常组)与增高者(增高组)各16例。通过HE染色观察炎症细胞浸润灶,甲苯胺蓝染色检测肥大细胞,免疫组化检测基质金属蛋白酶9(matrix metalloproteinase 9,MMP-9)、单核细胞趋化蛋白-1(Monocyte chemotaxis protein-1,MCP-1)和Ig E等表达。结果与血清Ig E正常组相比,增高组患者颞动脉血管壁炎症细胞浸润呈现出更高的发生率(62.5%vs12.5%,P0.01),1例伴外膜纤维素性渗出及小灶坏死的标本也见于Ig E增高组。Ig E增高组颞动脉MCP-1的平均光密度值[(9.25±5.79)×10~(-5)]高于正常组[(4.41±2.87)×10-5],差异有统计学意义(P0.01)。MMP-9的平均光密度值和内中膜厚度在血清Ig E增高组中均呈增加的倾向,但组间比较差异均无统计学意义(P0.05)。2组间肥大细胞计数差异无统计学意义(P0.05)。结论血清Ig E增高组患者颞动脉血管壁炎症细胞浸润、坏死反应和纤维素性渗出可能是血管炎的一种表现,推测MCP-1在病变过程中可能起到一定的作用。
[Abstract]:Objective to increase the level of serum immunoglobulin (E (immunoglobulin) IgE in some young patients with ischemic stroke, and to speculate that it is cerebrovascular inflammation, but there is no pathological basis. The purpose of this paper is to investigate the characteristics of vascular lesions in patients with temporal artery biopsy by histopathological study. Methods from January 2013 to August 2015, the specimens of temporal artery of 32 young patients with ischemic stroke with unknown etiology were examined by histopathological examination in the Department of Neurology, Nanjing General Hospital of Nanjing military region. There were 16 cases with normal serum Ig E (normal group) and 16 cases with elevated serum Ig E (elevated group). Inflammatory cell infiltration was observed by HE staining, mast cells were detected by toluidine blue staining, matrix metalloproteinase-9 (MMP-9), monocyte chemoattractant protein-1 (Monocyte chemotaxis protein-1,MCP-1) and Ig E were detected by immunohistochemistry. Results compared with the normal serum Ig E group, There was a higher incidence of inflammatory cell infiltration in the temporal artery wall (62.5 vs 12.5). One specimen with fibrous exudation and small focal necrosis of the outer membrane was also found in the increased Ig E group. The mean optical density of MCP-1 in the temporal artery was (9.25 卤5.79) 脳 10 ~ (-5) in the elevated group of Ig E [(9.25 卤5.79) 脳 10 ~ (-5)] Compared with the normal group [(4.41 卤2.87) 脳 10 ~ (-5)], the difference was statistically significant (P0.01) .MMP-9 's mean optical density and IMT were increased in the serum Ig E increased group. However, there was no significant difference in mast cell count between groups (P0.05). 2. There was no significant difference in mast cell count between groups (P0.05). Conclusion the inflammatory cell infiltration, necrotic reaction and cellulose exudation of temporal artery wall in patients with elevated serum Ig E may be a manifestation of vasculitis. It is suggested that MCP-1 may play a role in the pathogenesis of vasculitis.
【作者单位】：南方医科大学金陵医院(南京军区南京总医院)神经内科;南方医科大学金陵医院(南京军区南京总医院)皮肤科;南方医科大学金陵医院(南京军区南京总医院)病理科;
【分类号】：R743.3

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