CD68与α-平滑肌肌动蛋白在老年冠状动脉粥样硬化病变中的表达及意义

Expression and significance of CD68,α-SMA in senile coronary atherosclerotic lesion

目的:探讨CD68、α-平滑肌肌动蛋白(α-SMA)在老年人冠状动脉粥样硬化(AS)病变和弥漫性内膜增厚(DIT)中的表达,及其与AS病变类型、管腔狭窄之间的关系。方法:选用53例尸检病例的312份冠状动脉组织标本,光镜下诊断DIT和AS病变及其类型,用免疫组织化学和Scion图像软件系统,检测和计算AS病变中CD68-阳性巨噬细胞数和α-SMA阳性面积(%)、冠状动脉管腔狭窄程度、脂质坏死核心面积(%)和钙化基质面积(%)。结果:①CD68阳性巨噬细胞随着病变进展和管腔狭窄程度的加重而增多,呈正相关(r=0.351、0.197,P<0.01),而α-SMA阳性面积随着病变进展和管腔狭窄程度的加重而减少,呈负相关(r=-0.494、-0.362,P<0.01),两者在AS早期和进展期均差异有统计学意义(均P<0.05);②CD68阳性巨噬细胞、α-SMA阳性面积在AS不同病变类型、管腔狭窄程度以及胆固醇分组之间均差异有统计学意义(均P<0.05)。结论:老年人冠状AS病变内膜CD68阳性巨噬细胞增多及α-SMA阳性面积减少自始至终促进病变进展。

Objective：To study the expression and significance of CD68,α-SMA in senile patients with coronary ahtherosclerotic（AS） lesion and diffuse intimal thickening（DIT）,and explore the correlation between the expression of CD68,α-SMA and the lesion types of coronary AS,the degree of luminal stenosis. Method：Three hundred and twelve coronary artery tissue samples were selected from 53 autopsy cases.DIT and AS types were diagnosed by optical microscope.CD68 positive macrophages,α-SMA positive area（%）,lumen stenosis,lipid necrotic core（NC） and calcifying matrix area（%） were detected by immunohistochemistry and the Scion image software system. Result：①With the progress of AS lesion and the aggravation of luminal stenosis,the expression of CD68 macrophage increased（r=0.351,0.197,P〈0.01）,while α-SMA positive area decreased（r=-0.494,-0.362,P〈0.01）,and there were significant differences between early and advanced lesions（P〈0.05）.②The expression of CD68 macrophage and α-SMA positive area had significant differences among different lesion types,degree of luminal stenosis as well as cholesterol groups（P〈0.05）. Conclusion：Increased CD68 positive macrophages and decreased SMA positive area could promote the senile coronary lesions all along.