主动脉夹层患者升主动脉中层弹性蛋白与弹力纤维的变化

发布时间：2018-05-20 23:14

本文选题：动脉瘤 + 夹层　；参考：《中国普通外科杂志》2017年06期

【摘要】：目的:探讨Stanford A型主动脉夹层(AD)升主动脉中层弹性蛋白和弹力纤维变化。方法:收集10例Stanford A型AD患者术中获取的升主动脉管壁组织标本与10例脑死亡捐献手术中或冠状动脉旁路移植术中获取的正常升主动脉管壁组织标本,用Westernblot法检测两组标本中膜层弹性蛋白表达;用EVG弹力纤维染色分析两组升主动脉中膜层弹力纤维形态及含量。结果:Westernblot结果显示,AD升主动脉中膜层弹性蛋白含量较正常升主动脉明显降低[(0.32±0.07)vs.(1.12±0.17),t=6.722,P=0.003]。EVG染色结果显示,AD升主动脉中膜层弹力纤维形态和排列紊乱,弹力板层断裂、丢失,而正常升主动脉中膜弹力纤维排列紧密、有序,弹力板结构完整,层次分明;AD升主动脉中膜层弹力纤维含量较正常升主动脉明显降低[(85762.8±106.2)vs.(164482.8±161.4),t=5.902,P0.001]。弹性蛋白与弹力纤维含量在AD与正常升主动脉中膜层均呈明显正相关(r=0.953、0.973,均P0.001)。结论:StanfordA型AD患者升主动脉中层弹性蛋白和弹力纤维含量下降,弹力纤维形态和结构紊乱,该改变可能在AD的发生中起了重要作用。
[Abstract]:Objective: to investigate the changes of elastin and elastic fiber in ascending aorta of Stanford A aortic dissection. Methods: the ascending aorta wall tissue samples were collected from 10 patients with Stanford A AD and 10 normal ascending aortic wall tissues obtained during brain death donor operation or coronary artery bypass grafting. The expression of membrane elastin was detected by Westernblot method, and the morphology and content of elastic fibers in ascending aorta were analyzed by EVG elastic fiber staining. Results the content of elastin in the middle layer of AD ascending aorta was significantly lower than that of the normal ascending aorta [0.32 卤0.17 0.07)vs.(1.12 卤0.722 P0. 003] .EVG staining showed that the morphology and arrangement of elastic fibers in AD ascending aorta were disordered, and the elastic lamellar layer was broken and lost. However, the elastic fibers in the middle membrane of the normal ascending aorta were arranged closely and orderly, the elastic plate structure was intact, and the content of elastic fibers in the middle layer of AD ascending aorta was significantly lower than that in the normal ascending aorta [85762.8 卤161.4 106.2)vs.(164482.8 卤161.4 106.2)vs.(164482.8 卤5.902mP0.001]. The contents of elastin and elastic fiber in AD and normal ascending aorta were positively correlated with that in AD and normal ascending aorta, respectively (P 0.001). Conclusion the contents of elastin and elastic fibers in ascending aorta of patients with type A AD were decreased, and the morphology and structure of elastic fibers were disordered. This change may play an important role in the pathogenesis of AD.
【作者单位】：海南省人民医院血管外科;中南大学湘雅二医院血管外科;中国医学科学院阜外医院血管外科中心;
【基金】：海南省社会发展科技专项基金资助项目(2015SF04) 海南省卫生厅普通科研基金资助项目(14A210266)
【分类号】：R654.3

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