动脉粥样硬化血管的病理学研究

Study on pathology of blood vessel with arteriosclerosis

目的:探讨动脉粥样硬化的发生机制。方法:对7例动脉粥样硬化标本和6例成人尸检动脉标本,采用福尔马林固定,常规石蜡切片,苏木素-伊红染色,并采用光学显微镜进行观察。结果:动脉粥样硬化可分为弥漫性病变和局灶性病变。弥漫性病变血管与正常成人大动脉相比较,各层组织内有核细胞明显减少。弥漫性病变发病部位常为随机性,常涉及血管壁全层;局灶性病变以泡沫细胞克隆为特征,呈局部性。结论:动脉粥样硬化的弥漫性病变是长期血流动力学异常累积作用的结果,反复附壁血栓形成也促进弥漫性病变的进程。动脉粥样硬化的局灶性病变是在弥漫性病变基础上,成血管干细胞-内膜细胞-平滑肌细胞演化受阻,其过度性细胞的退行性克隆所致,局灶性病变的演化结果又使弥漫性病变进一步扩大、加重。

Objective; To explore the mechanism of arteriosclerosis, Methods; The arteries of 7 adult patients with arteriosclerosis and 6 adult without arteriosclerosis were removed en block in autopsy, fixed by formalin. The paraffin sections were normally cut, stained with HE, and observed by light microscope, Results： Arteriosclerosis was divided into the diffuse lesions and the focal lesions. Compared with the artery of normal adults, the nucleate cells of whole stratum decreased obviously in blood vessels with the diffuse lesions. Position of pathological changes in the diffuse lesions was not fixed. The pathological change in the diffuse lesions involved whole stratum of blood vessels. The focal lesions were characterized with foam cells cloned and were regional. Conclusion： The diffuse lesions of arteriosclerosis resulted from lasting abnormity of hemodynamics, and were moved forward by thrombosis. Based on the diffuse lesions, the focal lesions resulted from the suffocated evolvement of hemangioblast, the tunica intima cells and smooth muscle cells and the degenerative cloning of their transition cells. Evolvement of the focal lesions also made the diffuse lesions more enlarged and aggravated.