肝硬化门脉高压患者肝动脉与门静脉病理变化分析

发布时间：2018-02-04 01:33

本文关键词： 肝硬化高血压门静脉门脉高压性血管病变诱导型一氧化氮合酶　出处：《重庆医学》2017年20期 　论文类型：期刊论文

【摘要】：目的研究肝硬化后门静脉高压病例大血管血管壁的组织结构改变,探讨诱导型一氧化氮合酶(iNOS)在肝硬化发生进程中的作用。方法收集肝硬化肝移植病例的门静脉左支、左肝动脉和肝左静脉27例作为病例组,同期外伤性肝切除相应血管15例为对照组。分别予以HE染色、Masson染色,肝动脉加用弹力纤维染色和兔抗人iNOS多克隆抗体免疫组织化学。结果病例组门静脉内膜、中膜增厚,中膜平滑肌细胞增生、肥大,部分突出至内膜下;肝动脉内膜不规则增生,动脉管腔变窄,动脉壁内弹力膜变平、甚至断裂,中膜平滑肌向内膜增生;肝静脉壁组织结构没有明显改变。iNOS在肝动脉平滑肌细胞胞质呈高表达。结论肝硬化患者肝动脉与门静脉血管壁会继发组织结构重建,这是人体自身代偿机制的结果,iNOS的高表达加速了该组织结构重建的发生、发展。
[Abstract]:Objective to study the changes of tissue structure of large vascular wall in patients with portal hypertension after cirrhosis. To investigate the role of inducible nitric oxide synthase (iNOS) in the progression of liver cirrhosis. Methods the left portal vein, left hepatic artery and left hepatic vein were collected from 27 patients with liver transplantation. At the same time, 15 cases of the corresponding blood vessels were treated with HE staining and Masson staining. Results in the case group, the portal vein intima was thickened, the medial smooth muscle cells proliferated and hypertrophic, and some of them protruded to the subintima. The intima of the hepatic artery was irregular hyperplasia, the arterial lumen became narrow, the elastic membrane in the wall of the artery flattened or even broke, and the smooth muscle of the middle membrane proliferated to the intima. There is no obvious change in the structure of hepatic vein wall. INOS is highly expressed in the cytoplasm of smooth muscle cells of hepatic artery. Conclusion the hepatic artery and portal vein wall of liver cirrhosis patients will be secondary to tissue structure reconstruction. This is the result of the compensatory mechanism of human body. The high expression of iNOS accelerates the reconstruction of the tissue structure.
【作者单位】：四川省人民医院肝胆胰外科;四川大学华西医学中心肝脏外科;
【分类号】：R575.2
【正文快照】： 肝硬化门脉高压患者常并发有内脏血管的一系列病理结构重建,统称为门脉高压血管病变(portal hypertensive vascu-lopathy,PHV)。现有针对PHV的研究大都集中在脾血管、胃肠道静脉等处[1-3],而对人体肝静脉、肝动脉、门静脉的研究极少,只有一些动物实验的研究报道[4-6]。另外,一

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