摘要
目的 探讨稳定及不稳定斑块中巨噬细胞、T淋巴细胞及平滑肌细胞数量的差异及其与斑块稳定性的关系。方法 将急性心肌梗死死亡病例的尸检冠状动脉完整剥离后固定、脱钙、连续取材并常规切片及HE染色,按有无脂质中心及其大小将斑块分为稳定斑块( 斑块无或仅有较小的脂质中心) 及不稳定斑块( 脂质中心超过斑块的40 % )。选取2 种斑块各163 个,用CD68 、肌动蛋白、UCHL- 1 抗体分别对巨噬细胞、平滑肌细胞、T淋巴细胞进行免疫组化染色,并通过计算机图像分析系统对2 种斑块纤维帽中的3 种细胞进行定量。结果 不稳定斑块纤维帽中巨噬细胞及T淋巴细胞的面积百分比分别为89.6% 和32.5% ,稳定斑块分别为18.3% 和7.2 % ,差异均具有显著性( P<0.01) 。而平滑肌细胞在稳定斑块纤维帽中的面积百分比明显大于不稳定斑块,分别为68.4 % 和21 .8% ,差异具有显著性(P< 0.05) 。结论 稳定斑块与不稳定斑块不仅脂质中心大小不同,其纤维帽中炎细胞和平滑肌细胞的数量也不同,粥样坏死中心越大,其表面纤维帽中的巨噬细胞、T淋巴细胞就越多,而平滑肌细胞则越少。脂质中心大小和纤维帽中炎细胞数量是决定斑块稳定性的主要因素。
Objective To compare the content of inflammatory cells and smooth muscle cells in stable and unstable coronary plaques in order to clarify the role of these cells in the vulnerability of plaques. Methods Hearts from 12 postmortem acute myocardial infarction cases were studied. The epicardial coronary arteries were dissected en bloc, fixed, decalcified, cut at 4 mm intervals and routinely processed for HE sections. 163 stable plaques (with no or only little lipid core) and 163 unstable plaques (with lipid core size >40% of plaque area) were studied immunohistochemically using monoclonal antibodies specific for macrophages (CD68), T lymphocytes (UCHL 1) and smooth muscle cells (actin). Computor aided planimetry was used to measure the positive area of different cells. Results The content of macrophage and T lymphocytes in unstable plaques were significantly higher than that in stable plaques ( P <0.05). Conclusions Stable plaques and unstable plaques not only had different lipid core size but also had different inflammatory cell and smooth muscle cell content. The larger the lipid core and the more macrophages and T lymphocytes in the fibrous cap, the more unstable the plaque. The lipid core and inflammatory cells (including macrophages and T lymphocytes) are the two major determinants of the vulnerability of coronary plaques.
出处
《中华病理学杂志》
CAS
CSCD
北大核心
1999年第4期256-259,共4页
Chinese Journal of Pathology
关键词
心肌梗塞
巨噬细胞
T细胞
斑块
平滑肌细胞
Coronary arteriosclerosis
Macrophages
T lymphocytes
Image processing
computer assisted