纤维连接蛋白在颅内脑动脉瘤中的表达及动脉瘤壁纤维结构的特殊染色

Expression of fibronectin in patients with ruptured and unruptured intracranial cerebral aneurysmsand specific staining of aneurysm wall fiber structures

目的评价纤维连接蛋白在哈萨克族正常动脉壁及不同发展阶段的颅内动脉瘤壁（未破裂和破裂）中的表达和动脉瘤壁结构的特殊染色变化，来探讨颅内动脉瘤生长和破裂的可能机制。方法对12例哈萨克族多发颅内动脉瘤患者术中所获得的12个破裂与12个未破裂动脉瘤标本和尸体中所获得的5例正常颅内动脉标本进行纤维连接蛋白免疫组化染色和特殊染色，即Masson染色和网状纤维染色。结果纤维连接蛋白在正常血管壁和未破裂动脉瘤壁中表达不明显，而在破裂动脉瘤壁中表达较明显并与对照组比较差异有统计学意义（F=152，P=0．000）。破裂和未破裂动脉瘤壁特殊染色显示动脉瘤壁结构逐渐破坏。结论纤维连接蛋白可能参与动脉瘤的形成和破裂过程。颅内动脉瘤壁纤维结构逐渐破坏是动脉瘤形成与破裂的主要机制之一。

Objective To evaluate the differences in the expression of Fibronectin in the walls of difi^erent developmental stage of intracranial aneurysms（ ruptured and unruptured cerebral aneurysms） , and normal artery walls, as well as the specific staining of aneurysm wall structure, to discuss the possible mechanism of aneurysm growth and rupture. Methods Twelve paired specimen （ one was ruptured and the other one was unruptured in same patient, total 24 specimens） of cerebral aneurysms which of them obtained during the surgery for Kazakh patients with multiple cerebral aneurysms and the five specimen from the cadavers were immunohistologically stained for structural protein （Fibroneetin） and specific staining. Results Fibronectin was expressed less significantly in the normal arterial walls and unruptured aneurysm walls, and expression was significant in ruptured ones. Difference among the groups was statistically significant（ F = 152, P = 0. 000 ）. Specific staining of different stage of aneurysm walls showed gradual destruction of vessel wall structures. Conclusions The examined structural protein, Fibronectiu may be participated the aneurysm formation and rupturing process. Gradual destruction of aneurysm wall fiber structure is one of the key mechanisms of cerebral aneurysm formation and rupture.